Obesity is a disease that many people are struggling with, especially those with diabetes. For patients who have comorbidities and obesity-associated risk factors such as diabetes, weight loss is the pathway to their health improvement. Approved medications for weight loss can help them in managing their weight as well as other underlying conditions. However, when prescribing medicine for such patients, it is essential to use professional judgment.
Obesity is associated with many diabetes therapies, and patients can gain a lot of weight after they have started diabetes treatments (Pucci, 2018). Apart from prescribing medications, the Nurse practitioner should advise the patient to watch over her diet, behavioral modifications, exercise, and obesity and overweight management approach. Some of the behavioural changes to include should be increasing the regular physical activities and reducing the food intake. While some people might find it hard to do physical exercises, drugs can amplify adherence to behaviour changes and increase body functioning, making patients find it easy to exercise even if they could not do it earlier.
Since the patient’s family history shows she is at risk of coronary artery disease and is unable to maintain and lose weight, she is a candidate for weight loss medications. The professional judgment is that the patient should use the approved drugs without any pharmacological therapies (Lahey, 2018). Using these medications for patients with dyslipidemia, hypertension T2DM and obstructive sleep apnea, and those with BMI ≥ 30 kg/m2 or BMI of ≥ 27 kg/m2 will amplify behavioural changes and enhance physical functioning such as exercising hence a more remarkable weight loss.
Prescription of a regimen with one or more of the available drug classes, i.e. the GLP-1 agonist, metformin, and the new class of SGLT-2 inhibitors, will have a dual benefit of glycemic control and weight loss for this patient. Doctors recommend this medication because patients with subsets of diabetes may observe substantial weight loss with certain diabetes agents that also aid in lowering blood glucose. Therefore, before considering additional medications designed for a specific goal in weight loss, patients with diabetes should be advised to try one or more diabetes agents.
For patients with a history of cardiovascular diseases, giving medications that are not sympathomimetics should be the professional judgment. Drugs such as lorcaserin or orlistat are the most appropriate in this case (Pareek, 2018). Since patients with a history of cardiovascular attacks or those at risk of contracting cardiovascular attacks are vulnerable to sympathetic stimulation, they should use agents that do not contain cardiovascular signals preferentially. Clinicians should also consider the annual and symptoms of the patients based on the screening for major chronic illnesses associated with obesity in patients who have a BMI OF 30KGS/M2. This will guide them in the kind of medical prescription they should administer to the patients.
Even though the correct medication prescriptions will help her reinforce behavioural strategies and help her body create a negative energy balance, the nurse practitioner should make the patients aware that she needs to change her lifestyle when using the weight loss medications prescribed. A lifestyle program in addition to weight loss medication will result in a more significant weight loss. Besides, most weight loss medications amplify the effect of the behavioral changes and affect appetite making the patient start to consume lower calories. The automatic adherence to the diet leads to weight loss.
References
Lahey, R., & Khan, S. S. (2018). Trends in obesity and risk of cardiovascular disease. Current epidemiology reports, 5(3), 243-251. Web.
Pareek, M., Schauer, P. R., Kaplan, L. M., Leiter, L. A., Rubino, F., & Bhatt, D. L. (2018). Metabolic surgery: weight loss, diabetes, and beyond. Journal of the American College of Cardiology, 71(6), 670-687.
Pucci, A., Tymoszuk, U., Cheung, W. H., Makaronidis, J. M., Scholes, S., Tharakan, G., Elkalaawy, M., Guimaraes, M., Nora, M., Hashemi, M., Jenkinson, A., Adamo, M., Monteiro, M., P., Finer, N., & Batterham, R. L. (2018). Type 2 diabetes remission 2 years post Roux‐en‐Y gastric bypass and sleeve gastrectomy: the role of the weight loss and comparison of DiaRem and DiaBetter scores. Diabetic Medicine, 35(3), 360-367. Web.