Obese Patients and Weight Control

Introduction

The last several decades could be characterized by the significant alterations of the traditional peoples lifestyle. The rise of technologies and their implementation in the majority of activities performed by individuals during their lifespan resulted in the decrease of efforts needed to accomplish a certain task. Additionally, alterations could also be observed in food habits. The above-mentioned shifts of the traditional mode of life contributed to the dominance of ready-to-eat-food which has a great negative impact on the state of peoples health.

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Furthermore, the mass appearance of quick-service restaurants became another factor that preconditioned the evolution of the problem related to the populations food habits. Thus, an unbalanced diet and a lack of physical activity gave rise to numerous concerns with the extra weight. The problem of obesity became one of the most topical issues of the modern world, as even children suffer from the given problem. In this regard, the efficient method to struggle against the extra weight became the medical challenge of modern society. For this reason, the purpose of the given study is to summarize the main approaches to obesity in scientific literature and compare the efficiency of diet, exercises, and lifestyle modifications with bariatric surgery in the long-term perspective.

PICO statement

Considering the main aim of the given paper, there is a certain PICO question that could be formulated, resting on the main suggested goals.

The question sounds like:

  • In overweight patients, can diet, exercise, and lifestyle modifications, compared with bariatric surgery, improve patient health, and reduce overweight over one year?

PICO statement:

  • P: overweight patients,
  • I: diet, exercises, and lifestyle modifications,
  • C: compare with bariatric surgery,
  • O: improve patient health and reduce overweight,
  • T: one year.

This question shows that overweight patients are the target audience for our investigation. Yet, diet, exercises, and alterations of the mood of life are the main interventions that are expected to bring certain outcomes. These methods should be compared with the results bariatric surgery might guarantee to patients. Finally, the gradual improvement of the quality of life and state of the patients health compared with the reduced overweight should be considered the desired outcomes. The term is one year.

Background

The choice of the given research topic is not accidental. It is preconditioned by the specific background that increases the topicality of the issue and results in the increased importance of the study of this sort. Yet, according to Marihart, Brunt, and Geraci (2014), the significant deterioration of the situation could be observed. The percentage of people suffering from obesity increases every year (Menzo, Szomstein, & Rosenthal, 2014), and the quality of their lives suffer. Additionally, being a great medical problem, it also results in the appearance of numerous complications with the heart, blood vessels, spine, that suffers from a great burden, joints, lungs, and genitals (Menzo et al., 2014). All these facts contribute to the outstanding significance of the problem under investigation. However, accepting the necessity of weight control, specialists, though, differ in their approaches to remedies that should be used to accomplish this task. There are adherers of the idea that diet, exercises, and alterations of the lifestyle could have a positive impact on a patients health. Nevertheless, some specialists insist on bariatric surgery as the most efficient method to struggle against obesity. For this reason, the great topicality of the given research becomes obvious.

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Nursing practice

Another fact that contributes to the great importance of the given aspect is its strong bond with the nursing practice. A modern nurse performs an array of important tasks needed to assure the delivery of care and a patients state improvement. These include education, teaching, and control of the environment under which people live. For this reason, the problem of extra weight is closely related to nursing practice. A qualified nurse should be able to admit the first dangerous signs of obesity and warn a patient about the possible complications that might appear in case the problem is disregarded. Furthermore, a nurse should also be able to state a nursing diagnosis and create a list of appropriate interventions that could be used to guarantee a patients recovery and attain a significant improvement of his/her state (Menzo et al., 2014). Additionally, a nurse might also provide recommendations about the treatment plan and procedures that should be used to assist a patient in his/her recovery.

Accepting the unique significance of this problem, investigators also try to provide a scientific rationale for the choice of the appropriate treatment and method to struggle against obesity. Besides, Barte, Veldwijk, Teixeira, Sacks, and Bemelmans (2014) in their article Differences in weight loss across different BMI classes: A meta-analysis of the effects of interventions with diet and exercise try to investigate the impact these interventions have on patients suffering from extra weight. They state that lifestyle alterations could be recommended only for persons with a BMI of 25-40 kg m, but the heterogeneity of this group might influence the outcomes of possible interventions (Barte et al., 2014). Thus, in their review, the authors trace differences that occur in people belonging to this group. Therefore, the research was focused on weight change during lifestyle interventions. The authors conclude that these methods could be recommended for the classes characterized by the above-mentioned BMI. The given research proves the great practical use of the above-mentioned alterations of the lifestyle, however, they might be less efficient in case applied for other groups with different BMI.

Camhi, Crouter, Hayman, Must, and Lichtenstein (2015) in their research also provide a scientific rationale for the necessity of different interventions to control patients BMI. They delve into convergences in lifestyles peculiar to physically active or sedentary behaviors among metabolically healthy/overweight ad metabolically unhealthy/overweight women (Camhi et al., 2015). The research aims to determine whether these aspects impact the quality of peoples life or not. In the course of the investigation, the authors distribute a specific questionnaire designed to determine alterations in lifestyles and the theoretical impact weight has on women. At the end of the paper, the authors state that young females with less sedentary behavior could be characterized by healthier lifestyle habits and healthier dietary quality (Camhi et al., 2015). It means that physical activity remains one of the main factors that impact the quality of peoples life and might be considered a guarantee of the absence of problems with obesity or extra weight. The given research could be explored in terms of the given paper to prove the great significance and the possible alterations of the mode of life and physical activity related to it.

The issue is also touched upon in the paper by Mason et al. (2015). It is focused on the exploration of compensatory metabolic changes that come along with weight loss and decrease the probability of long-term results that are needed to guarantee the significant improvement of the lifestyle. For instance, the increased ghrelin, or the hunger hormone, might trigger the appearance of a greater appetite and prevent a patient from further weight loss. For this reason:

researchers conducted a 12 month randomized and controlled trial comparing: i) dietary weight loss with a 10% weight loss goal (‘diet’; n = 118); ii) moderate-to-vigorous intensity aerobic exercise for 45 min/day, 5 days/week (‘exercise’; n = 117); iii) dietary weight loss and exercise (‘diet + exercise’; n = 117); or iv) no-lifestyle-change control (n = 87). (Mason et al., 2015, p. 371)

In the course of the given investigation authors conclude that ghrelin increases significantly in case diet is combined with physical exercises for this reason greater weight loss should always be associated with increased hunger hormone (Mason et al., 2015). This fact makes the intervention that implies diet and exercises more complex. For this reason, the given article might provide some facts for the usage of bariatric surgery to control the weight and assist people in weight loss.

Furthermore, Johns, Hartmann-Boyce, Jebb, and Aveyard (2014) continue the investigation of the topic and provide their research that revolves around diet or exercise interventions vs. behavioral weight management programs. The authors also admit the fact that weight is one of the factors that might trigger the appearance of different complications and significant deterioration of the quality of life. For this reason, the alterations of weight and its decrease can reduce the possibility of the appearance of any complications. Thus, “the most effective method of weight loss remains unclear” (Johns et al., 2014, p, 1557).

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Certain programs are focused on physical activity when other interventions promote diet, but existing evidence is mixed as it remains unclear whether these are more effective alone or in combination (Johns et al., 2014). In this regard, their research aimed to “examine the clinical effectiveness of combined behavioral weight management programs (BWMPs) targeting weight loss in comparison to single-component programs, using within-study comparisons” (Johns et al., 2014, p, 1557). Resting on the results of numerous studies conducted in a short period, Johns et al. (2014) conclude that “weight loss is similar in the short-term for diet-only and combined BWMPs but in the longer-term weight loss is increased when diet and physical activity are combined” (p. 1568) Moreover, programs that are based on physical activity without any additional interventions or measures are less effective than the mixed ones in both the short and long term (Johns et al., 2014).

Evidence-based practical changes

Resting on the results of the above-mentioned studies, it is possible to assume that the combination of different methods to control weight and improve the quality of patients lives shows better results than any other method alone. Yet, there are still numerous debates related to the advantageous or disadvantageous character of bariatric surgery or alterations of the mode of life. Besides, at the moment both these methods are explored by the health care sector and show good results. However, the latest investigations and evidence-based practice preconditioned the increased attention given to the combination of diet, physical activity, and the alterations of the lifestyle that could help a patient to recover. This method is often taken as less dangerous, and it could guarantee long-term results.

Conclusion

Altogether, extra weight could be considered one of the most topical issues of the modern healthcare sector. In this regard, there are numerous attempts to control it and improve the patients state. Thus, there is the opposition diet, exercise, and lifestyle modifications vs. bariatric surgery. Both these approaches could be considered efficient enough; thus some facts might prove the advantageous character of the first one. However, additional research is still needed.

References

Barte, J., Veldwijk, J., Teixeira, P., Sacks, F., & Bemelmans, W. (2014). Differences in weight loss across different BMI classes: A meta-analysis of the effects of interventions with diet and exercise. International Journal Of Behavioral Medicine, 21(5), 784-793. Web.

Camhi, S. M., Crouter, S. E., Hayman, L. L., Must, A., & Lichtenstein, A. H. (2015). Lifestyle behaviors in metabolically healthy and unhealthy overweight and obese women: A preliminary study. Plos One, 10(9), e0138548. Web.

Johns, D. J., Hartmann-Boyce, J., Jebb, S. A., & Aveyard, P. (2014). Diet or exercise interventions vs combined behavioral weight management programs: A systematic review and meta-analysis of direct comparisons. Journal Of The Academy Of Nutrition & Dietetics, 114(10), 1557-1568. Web.

Marihart, C., Brunt, A., & Geraci, A. (2014). Older adults fighting obesity with bariatric surgery: Benefits, side effects, and outcomes. SAGE Open Medicine, n. pag. Web.

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Mason, C., Xiao, L., Imayama, I., Duggan, C. R., Campbell, K. L., Kong, A., &…McTiernan, A. (2015). The effects of separate and combined dietary weight loss and exercise on fasting ghrelin concentrations in overweight and obese women: A randomized controlled trial. Clinical Endocrinology, 82(3), 369-376. Web.

Menzo, L., Szomstein, S., & Rosenthal, R. (2014). Changing trends in bariatric surgery. Scandinavian Journal of Surgery, 104(1), 18-23. Web.

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