Obesity †case study and health promotion paper Essay

corpulency has reached global epidemic pro muckles, and has turn a major wellness surdy of out society. According to Peeters et al. (2007), 32% or 60 million people ar now obese in the join States. The rail develops as a final takings of the interaction in the midst of genetics, bread and entirely ifterstyle behavior, and pagan and environmental influences. Fat accumulates when more than than push is consumed than expended. The National Heart, Lung, and Blood Institute (NHLBI) has adopted a classification system of bole mass index (BMI). BMI, the indirect cadency of body naughty, identifies the over burthen and obese respective(prenominal)s. A BMI of 25-29 kg/m2 is considered over encumbrance, 30-34 kg/m2 is mild fleshiness, 35-39 kg/m2 is moderate fleshiness, and above 40 kg/m2 is extreme obesity (Palamara, Mogul, Peterson, Frishman, 2006). corpulency develops receivable to steep- plentiful, richly lolly viands coupled with a decline in strong-arm activ ity. Modern invigoration conditions, eating habits, and prime(prenominal) of forage lead to over-consumption of cheap, super size portions. More cars, roads, and fast fodder restaurants at e precise corner, as well as quick, ready to eat microwavable dinners loaded with naughty, salt, and artless scratchs ar easier and often less dear(predicate) than nutritious, quality food products. Furthermore, the technology has do humans rely on mechanic devices. The automated inventions designed to make liveness easier, perform super acids of tasks that in the past undeniable material labor. As a result of sedentary life and over-consumption, the unornamentedive gamy accumulates in the body, and may become material health consequences.Multiple research studies decl be revealed that excessive cant gain gains the pretend of diabetes, hypertension, dyslipidemia, coronary heart illness, stroke, osteoarthritis, and m each forms of cancer. In particular, abdominal obesit y has been recognized as strongly associated with the development of diabetes and cardiovascular diseases (Behn & Ur, 2006) (Chen et al., 2007) (Balkau et al., 2007) (Despres, 2007). ascribable to the dangerous health jeopardys of obesity, it is considered a disease that leases intervention (Palamara et al., 2006). The Centers for ailment Control and legal community (n.d.) estimated that medical exam expenses related to obesity court $92.6 billion in the year 2002, and the condition causes 300,000 deaths per year.Nevertheless, prevention of the multiple health consequences of obesity is possible by pitch simplification. Bardia, Holtan, Slezak and Thompson (2007) suggested that redden a sm either starting timeer in a patient roles clog would result in better manipulate of multiple diseases, enhance quality of life, greatly improve a patients morbidity, and result in scummyer health c atomic subjugate 18 use and medical be. In addition to preventing many diseases, angle simplification can improve the already present disorders. Research indicates that cant over disadvantage of 4% to 8% is associated with a decrease of systolic and diastolic rip nip by 3 mmHg (Mulrow et al., 1998). The main freight uniter from Decatur cut back interventions include fodder, enjoyment, psychological, behavioral, pharmac a nonher(prenominal)apy, surgery, and alternative therapies (Vlassov, 2001).However, the abundant term utileness of these interventions has non be sound, as majority of people encounter their angle after losing it (Biaggioni, 2008). Guidelines for incubus simplification suggested by NHLBI involve the fol sufferinging initial decrement of 10% of body burden, execrable calorie pabulum (800-cl0 kcal/d) 30% calories from fat, 15% calories from protein, and 55% calories from sugars, fooling deficit of 500-1000 kcal to withdraw wizard to devil beats per week during sextette months, huge term encumbrance charge, and so matogenic activity for 30 to 45 proceedings three to quintette eld a week (Palamara et al., 2006). Health c ar providers are faced with the prevention and instruction of a major cause of morbidity and mortality for which effective life long interventions are desperately needed.CASE STUDY bobsleigh is a 38 year anile white male. Except for hypertension, he considers him ego healthy. He has seen his family doctor three months ago for weak blood pressure check up, as he does e actu solelyy six months. dog is married, has four adolescent children, and works as an automobile dealer for fourteen years. g superstar medical history hypertension, obesity, hyperlipidemia every last(predicate)ergies no(prenominal) to medications, latex, animals, foods, or environmentalHospitalizations / surgeries / injuries tonsillectomy in childhoodMedications lisinopril 20mg or everyy dailyFamily medical history m early(a) and brother with hypertensionSocial history lives with wife and children, completely very supportive of each other, quarter along well,drinks 2 glasses of whiskey sociall(a)y on weekends, denies smoking or illicit substance usestrong-arm activities walks on treadmill for twenty proceeding once or twice a week, occasionally plays volleyball with family on weekends workaday white plague patterns breakfast four sandwiches with tall m furnish and ham lunch home do soup, cooked or fried sausage dinner salad, lots of potatoes, 2 portions of steak or meatloaf or chicken, pickled ve pointables supper pasta with be waste or pizza snacks chips, cookies, candy, pretzels and fruits, all end-to-end the day fluids 8 glasses of soda, juice, pee or milk.Review of systems unremarkable, no complaints. lading 280 pounds, Height 63, shank circumference 52, BMI 35kg/m, BP 150/90 mmHgMost recent irregular laboratory tests join cholesterol 220, triglycerides 310All other results including glucose, blood count, BUN, creatinine, and liver enzymes were inside n ormal range. phellem admitted that cant going a focussing has been one of the greatest challenges forhim. His several preliminary acts at weight decrement constitute been un thriving. He verbalized unstrainedness and readiness to humble once again, merely was concerned that he would non be able to follow the design long term. corks family was very supportive, and willing to sponsor with his weight harm attempts. To identify the health dangers of obesity, and to determine interventions to slim down those essays, research articles were examined. The search for relevant studies was conducted use OVID MEDLINE, PUB MED, CINAHL, and COCHRANE databases.SUMMARY OF LITERATURE sustenanceingetic interventions form the fundamental element of the circumspection of obesity. in that respect is a wide shape of possible viandss, but no consensus on which is the most effective for weight reduction. A review by Noakes and Clifton (2004) compared the effect of a low cabbage diet and a low fat diet. Overall, the studies revealed that a very low carbohydrate diet resulted in significantly more weight redness than low fat diet in the short to medium term. On the other hand, a moderately low carbohydrate diet resulted in comparable weight hurt as a low fat diet. Moreover, the very low and moderately low carbohydrate diets have been make to more effectively cut out triglyceride, and adjoin high density lipoprotein (HDL) levels compared to low fat diet.Again, comparison between the low carbohydrate and low fat diets was performed by Lecheminant et al. (2007). In a quazi-experimental design, 102 participants were assigned either to a low carbohydrate (LC) or a low fat (LF) radical. Both groups followed a very low postal code diet and missed significant body weight (LC 20.4 kg, LF 19.1 kg) and waist circumference. The differences between the two groups were not statistically significant. In addition to the diet, all participants were gnarly in b adve nture walk 300 minutes per week, and all were issued pedometers to varan their progress. Also, two groups were every bit effective at preventing weight re-gain over six months, and both groups were set up to have a change magnitude blood pressure as a result of weight loss.Similarly, a taxonomical review by Pirozzo, Summerbell, Cameron and Glasziou (2002) compared the effects of a low fat diet to low calorie diet and low carbohydrate diet. Six randomized program lineled footraces with a total of 594 participants were analyse over a menstruation of six to eighteen months. Overall results demo non-significant differences in weight loss, weight maintenance, serum lipids, and blood pressure between all the diets reviewed.Moreover, a one year randomized trial by Dansinger, Gleason and Griffith (2005) compared Atkins, Zone, Weight Watchers, and Ornish diets. A single center randomized trial assigned 160 participants among the four diet groups. After one year, all diet groups w ere put in to have significantly keep down weight and waist size, without significant differences between groups. Similarly to previous studies, low carbohydrate diets reduced triglycerides and diastolic blood pressure, all miss Ornish diet group extend high density lipoprotein (HDL), and all except Atkins diet group reduced low density lipoprotein (LDL).In addition to cleverness restriction through the diet, energy consumption may enhance weight loss. In a meta-analysis by Shaw, Gennat, ORourke and Del cross (2006), 41 randomized controlled clinical trials were analyzed to determine the effects of usance in backbreaking and obese adults. The multiple exercise interventions included walkway, jogging, cycle ergometry, weight training, aerobics, treadmill, dance tread tonicityping, dancing, ball games, calisthenics, rowing, and aqua jogging. The 3476 participants exercised three to tailfin old age a week for a median duration of forty five minutes a day. Several of the s tudies compared exercise to diet either whole or in combination with exercise. The results revealed that exercise alone led to marginal weight loss, but when combined with diet pleadd significant weight reduction.Moreover, comparing the intensities of the various types of exercise activities, it was found that both high and low forcefulness exercises were associated with weight loss. Nonetheless, high intensity bring forth only slightly more weight reduction than low intensity, but when the diet component was added, the difference between high and low intensity was not significant. Additionally, the findings revealed that systolic blood pressure reduction was prospered by diet over exercise, and diastolic bloodpressure was reduced tallyly likely by exercise as by diet. Furthermore, exercise did not reduce cholesterol levels, but was found to reduce triglycerides equally well as diet. Patients involved in the exercise trials improved diastolic blood pressure, triglyceride, high density lipoprotein, and glucose levels regardless of whether they lost weight.One of the most difficult aspects of weight loss plans is consistent estimation to exercise. A meta-analysis by Richardson et al. looked at the effects of walk on weight reduction (2008). 307 participants in nine interventional studies were provided with pedometers to observe step count. Pedometers served as pauperismal tools to self manage and reach the oddments of walking. The participants logged the daily recorded move, and reviewed their results during group meetings. On average about 0.05 kg was lost per week after walking two gibibyte to four thousand steps per day. Although the amount of weight lost in the trials was diminutive, bail bond to walking programs and increase step count according to plan goals is Copernican for the undecomposed effects on health. The tangible activity reduced the bump of cardiovascular events, lowered blood pressure, and table serviceed exercise lea n muscle mass of the participants. The studies have shown that the use of pedometer is helpful in supervise the progress of physical activity, and is a steady-going way to motivate rund increase in walking.Another meta-analysis compared different psychological interventions and their effects on weight reduction (Shaw, ORourke, Del Mar, Kenardy, 2005). 36 randomized controlled clinical trials including 3495 participants were evaluated. The majority of studies assessed the effects of behavioral interventions on weight loss. The duration of clinical polish off with the participants ranged from 7 to 78 weeks, with sessions dour 60 minutes weekly. The techniques included stimulus control, goal setting, and self- monitoring. The therapies enhanced dietetical restraints by providing reconciling dietary strategies, and by change magnitude demand for physical activities, and to maintain adherence to the healthy lifestyle.Behavioral therapy was successful at fall weight as a stand- alone strategy (2.5 kg), and even greater weight reduction was attained when combined with diet and exercise (4.9 kg). Several evaluated studies alike assessed cognitivetherapy, psychotherapy, relaxation therapy, and hypnotherapy, but the results of these either did not reveal significant weight reduction, or resulted in weight gain. Moreover, a number of studies found that weight loss was associated with reductions in systolic and diastolic blood pressure, serum cholesterol, triglycerides, and fasting plasma glucose. These findings once again confirm the important health benefits of reducing weight.Overall, the research suggests that most diets are equally effective at weight reduction. There are multiple more or less popular diets known, and according to Dansinger et al. (2005), more than one thousand diet books are now accessible. Instead of searching for the trump out available, obese patients should be advised that any diet would be more effective than the one they are curren tly consuming. Moreover, diet modification has been shown to be more effective than exercise, but both are beneficial in reducing cardiovascular attempt factors. illustration does not have to be intense, and walking on most days of the week is sufficient for risk reduction when protractd long term. Finally, addition of behavioral interventions may strengthen motivation and self monitoring, and enhance weight loss maintenance.INTERVENTIONS AND RESULTS move was presented with the literature findings on health risks and health promotion, and was back up to lose weight by diet, and involvement in more physical activities. He was introduced with the possible options, and it was recommended that he participates in designing his weight loss plan. This way dog could have more control over the interventions, and was able to incorporate his preferences. cork identified his perceived benefits of losing weight as improved body image, mood, physical physical fitness and agility, reduced b lood pressure, and reduced risk of comorbidities. The main barriers were mainly the resistance to go past favorite foods, and occasional laziness to perform physical activities.Instead of starting one of the multiple popular diets, docking facility unflinching to reducehis portion sizes initially by 30%, substitute supper and snacks by fruits and vegetables, and take place soda and juice. To assure smaller portion sizes, tag was back up to use a smaller plate than usual. He in addition agreed to drink at to the lowest degree two liters of water a day, in particular with meals, to reach satiety sooner. He was encouraged to keep a journal of all his daily intakes of food and drink to monitor his diet, and to identify some hidden sources of excess consumption. Moreover, to avoid excess eating, bobber was instructed to only eat at the table, and to not allow family members to eat any food eyepatch sitting on the couch or in front of the computer.He also decided to become mor e physically active, and his choice of daily exercise was walking. cork was encouraged to purchase a pedometer to monitor progress in physical activity, aiming for at least two thousand steps a day. Richardson et al. (2008) informed that a two thousand step walk was estimated to equal one mile. curtsy was also encouraged to set weekly walking goals, soft increasing his step count. Bobs family was also involved in his attempt to lose weight. To help him attain his goals, family members planned to show support for Bobs exercise by joining him. Furthermore, Bob was encouraged to identify situations of daily living providing opportunities for more physical activities, for example set further away from the entrance at work and grocery store.Weekly meetings evaluated Bobs progress, and discussed about difficulties of following the plan. Bob remained strongly motivated throughout the eight weeks of intervention, and successfully reached most of his weekly dietary and exercise goals. Po rtions of his meals rock-bottom steadily until no more than 50% of initial food intake was reached, and the snacks included fruits and vegetables only. Daily step count reached up to six thousand steps on some days, and daily walks through the park with his wife became an enjoyable routine. To everyones surp put on, during the third week Bob decided to accompany his sons to the health connection twice a week, where he swam in the pool for one hour.He convey feeling energized after any physical activity. Several small relapses were recorded when Bob missed a couple days of walking, and could not resist eating high calorie or high fat foods. At the end of eight weeks of interventions, Bob has lost nine pounds, reduced his BMI to 33.9 kg/m, and his waist circumference decreased by 1.25 inches.Also, his systolic and diastolic blood pressure was slightly reduced. Unfortunately, the effect on the blood lipid level has not been tested. In conclusion, during only eight weeks Bob turned from moderately obese to lightly obese, and remained motivated to continue the weight loss plan.DISCUSSIONResearch has revealed that any diet, as long as caloric intake is restricted, will result in weight loss. It has been calculated that to lose one pound a week, one has to restrict food intake by 500 kcal per day. Patients often get discouraged by the disinclined effects of weight loss. On the other hand, studies point that more restrictive diets have lower compliance rates and increase weight regain (Palamara et al., 2006). Unfortunately, losing theweight is not the biggest challenge. What people mostly fail at is maintaining the reduced weight. Effective weight maintenance requires not only decreasing energy intake and increasing energy expenditure, but also modification of behaviors that predispose to weight gain.Bob monitored his daily dietary intake, and avoided situations spark advance to overeating. Also, the pedometer monitored the amount of walking, and served as a mo tivational tool. Moreover, congenital motivation for physical activities, as described by Teixeira et al. (2006), is the atonement from combat-ready in an activity, while extrinsic motivation describes the desire of slimmer appearance, and weight management. The authors presented that the extrinsic motives correlated with short term weight loss, whereas native motives predicted long term results. Bob expressed enjoyment of daily walks through the park, which correlates with intrinsic motivation, and because he is likely to continue over longer period of time. It is important that diet or exercise is maintain for the pleasure and positive feelings brought on by the activity.IMPLICATIONS OF FINDINGS FOR CLINICAL PRACTICEThe continuing rise in obesity and related risk factors, and failure of maintaining long term weight loss result in increasing prevalence of comorbidities. Health care cost related to treating ailments resulting from obesity will continue to rise, unless health c are providers utilize more effective measures to deal with the problem. Promoting healthy victual and lifestyle early in life may prevent the development of obesity. It is a great challenge for nurse practitioners to help patients maintain their weight. Although the recommended musical compositions of various diets include specific amounts of fats, carbohydrates, and protein, the research revealed that it is the total caloric capability that is responsible for weight loss, regardless of nutritive partitioning. Once the patient is ready and willing to rip, the treatment strategy should be devised together. Since the course of diet options have been shown to have similar effects, the nurse practitioner can help match the nutritional plan with patients dietary preferences.Although diet was found to be more effective in weight reduction than exercise, patients with cardiovascular risk factors should beeducated about the benefits of physical activities. It is important to encourag e dogging federation in exercise, even when no reduction of weight is observed. Lifestyle changes can be difficult to sustain for the patient, hence continuous support and motivation by a nurse practitioner are necessary. The interventions require dedication of both, the patient and the nurse practitioner. Also, focussing patients family, and encouraging to get involved in loved ones struggle through weight loss and weight maintenance may provide additional support, and contribute to lasting behavior changes. Behavioral strategies such as encouraging setting distract goals, self monitoring and evaluation may increase the chance of success. Patients satisfaction with the choice of diet and physical activity, and successful long term adherence are the best predictors of lifelong weight maintenance. completionThe comorbidities associated with obesity substantially lower the individuals quality of life, and are also becoming an enormous burden on health care. Successful treatment an d prevention of obesity can reduce the item of its complications. Dieting is resented by most individuals, therefore it is necessary to assist patients to find appropriate and motivating interventions that can be successfully followed life long. Patients willingness to commit to a long term adherence is essential to permanent lifestyle changes. It is a long and difficult journey from decision making to lose weight to the successful long term results, but even small losses of weight can produce important health benefits.REFERENCESBalkau, B., Deanfield, J.E., Despres, J.P., Bassand, J.P., Fox, K.A., Smith, S.C.Jr., Barter, P., Tan, C.E., Van Gaal, L., Wittchen, H.U., Massien, C., Haffner, S.M. (2007, October). outside(a) Day for the Evaluation of Abdominal fleshiness (IDEA) a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries. _Circulation, 116_(17), 1942-51. Retrieved February 5, 2008, fromOVID MEDLINE data base.Bardia, A., Holtan, S.G., Slezak, J.M., Thompson, W.G. 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