Introduction
Obesity in adult patients is a big problem in the United States. Over 20% of the population in each state is obese (Fruh, 2017). This presentation will explain the importance of the issue to nurse practitioner practice and the impacts of obesity on health outcomes. It will also compare the effect of counseling and behavior modification on weight loss to the group of obese people without counseling. The literature review and recommendations for the practice change will be addressed.
Practice Issue
Obesity in Adult People
Obesity is a complex disease involving excessive fat accumulation, which leads to numerous health risks (Schetz et al., 2019). If a personās body mass index (BMI) is higher than 30 kg/m2, they are considered obese (Schetz et al., 2019). The main causes of obesity are psychological, physiological, and inherited factors, nutrition, physical activity, and exercise choice. In the US, obesity is an epidemic because more than 20% of each stateās population suffers from excessive weight (Fruh, 2017). To prevent obesity, nurses should provide their patients with nutritional advice and create individual weight management programs.
Importance of the Issue to Nurse Practitioner Practice
The issue of obesity is important to nurse practitioner practice because it leads to various health risks and increases sickness rates. Nurses will have to deal with patientsā chronic conditions and complications in ICU patients (Schetz et al., 2019). Moreover, working with obese patients is physically and emotionally demanding, so nurses need to find an individual approach to every patient and provide specific recommendations and care.
Impact on Health Outcomes
Obesity has a negative impact on health outcomes. It may lead to such problems as hypertension, coronary artery disease, chronic heart failure, stroke, type 2 diabetes, and other comorbidities (Fruh, 2017). Moreover, obesity increases the risks of polycystic ovaries and infertility in women and decreases menās libido and sexual function (Fruh, 2017). Obese patients are more likely to develop chronic kidney failure and acute kidney injury (Schetz et al., 2019). ICU patients may develop obstructive apnea syndrome or severe hypoxemia (Schetz et al., 2019). Finally, the immune system suffers, and patients may not cope with infections.
PICOT Question
- In adult patients with obesity, what is the effect of counseling by the health care provider and behavior modification compared to the group without the counseling on weight loss of 10 lbs. or more to be completed over one year?
- P (Population): Adult patients with obesity
- I (Intervention): Counseling by the health care provider and behavior modification
- C (Comparison): The group without counseling
- O (Outcome): Weight loss of 10 lbs. or more
- T (Time): One year
The nursing practice concern is adult people with obesity because this population is at increased risk of developing comorbidities and complications, thus resulting in negative health outcomes. The evidence-based solution for the problem will be counseling and behavior modification. The outcomes will be compared to the group without counseling. The timeline for the EBP initiative will be one year.
Literature Review
Summary
Obesity is considered an epidemic in the USA since it is highly spread (Fruk, 2017; Schetz et al., 2019). Nurses often find obese patients lazier than normal-weight patients, and taking care of them is emotionally challenging (Robstad et al., 2018). Health care practitioners believe that obesity should be treated as a chronic disease because even if a person loses weight, they are likely to regain it in the future (Semlitsch et al., 2019).
Themes and Special Concerns
Multidisciplinary specialists consider metabolic and bariatric surgery the gold-standard treatment for severe obesity (Heymsfield et al., 2018). At the same time, lifestyle modifications and psychological support are essential elements for obesity treatment. Since the biggest concern of this disease is all-causes of death, nurse practitioners should try to prevent obesity, using counseling and behavior modifications for patients at risk (Semlitsch et al., 2019).
Unique Perspectives
Obesity is often associated with psychosocial stress, psychological issues, and ineffective attempts to lose weight (Semlitsch et al., 2019). Sometimes, antipsychotics, antidepressants, and other medicines may contribute to abnormal weight gain or restrict patientsā ability to lose weight (Heymsfield et al., 2018). Moreover, policy implications, such as a lack of insurance coverage or low physician reimbursement rates, may become challenges for obesity treatment (Heymsfield et al., 2018).
Recommendations
Evidence-Based Recommendation
The main EB recommendations will include behavior and diet modification counseling. Nurse practitioners should provide dietary interventions with a daily energy deficit of 500 to 750 kcal (Semlitsch et al., 2019, p. 1223). Increased physical activity and behavioral and psychological support are also recommended.
Key Stakeholders
The main stakeholders impacted by the recommended change will be obese adults because they will lose weight; nurse practitioners, because they will need to find an individual approach to every patient; policymakers who will need to reconsider policies and include obesity in insurance coverage; and public health officials who will need to consider the methods of obesity prevention.
Fit, Feasibility, and Appropriateness
The recommendations can be implemented within the current organizational structure because they do not require big financial investments. Sometimes, additional psychological consultations are needed. Clinical outcomes will improve for patients with other chronic diseases after losing weight.
Conclusion
Obesity is a big problem in the US. Nurse practitioners can address this problem, providing obese patients with counseling and behavior modifications. Consequently, health outcomes will improve for nurses and patients.
References
Fruh, S. M. (2017). Obesity: Risk factors, complications, and strategies for sustainable longāterm weight management. Journal of the American Association of Nurse Practitioners, 29(S1), S3-S14.
Heymsfield, S., Aronne, L. J., Eneli, I., Kumar, R. B., Michalsky, M., Walker, E., Wolfe, B. M., Woolford, S. J., & Yanovski, S. (2018). Clinical perspectives on obesity treatment: Challenges, gaps, and promising opportunities. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. Web.
Robstad, N., Sƶderhamn, U., & Fegran, L. (2018). Intensive care nursesā experiences of caring for obese intensive care patients: A hermeneutic study. Journal of Clinical Nursing, 27(1-2), 386-395. Web.
Schetz, M., De Jong, A., Deane, A. M., Druml, W., Hemelaar, P., Pelosi, P., Pickkers, P., Reintam-Blaser, A., Roberts, J., Sakr, Y., & Jaber, S. (2019). Obesity in the critically ill: A narrative review. Intensive Care Medicine, 45(6), 757-769. Web.
Semlitsch, T., Stigler, F. L., Jeitler, K., Horvath, K., & Siebenhofer, A. (2019). Management of overweight and obesity in primary care: A systematic overview of international evidence-based guidelines. Obesity Reviews, 20, 1218-1230. Web.