The Patient and Their Unhealthy Lifestyle Choice
Mrs. AK, a 29-year-old married woman, has two children: a 7-year-old daughter and a breastfed 2-year-old daughter. She is working from her residence and does not go out much (Wu et al., 2024). Mrs. AK has no long-term illnesses and was found to be in good health.
However, she has been complaining of constant heartburn in the evenings for the past 6 months. Her medical history includes cervical erosion with grade 1 dysplasia. Mrs. AK lives a sedentary lifestyle, does not smoke, and consumes small amounts of alcohol on holidays. Her current weight is 214 lb, height is 5ft and 4 inches, waist circumference is 4ft, and blood pressure is 120/80. Her doctor believes she needs to lose weight.
Assessment for the Specific Unhealthy Lifestyle Choice
The patient’s Body Mass Index (BMI) should be calculated, so 214 lb x 703 = 150,442, 150,443/64 inches = 2350.65625 /64 inches = 36. According to the BMI classification, she is obese class II, and her high body weight may pose a significant morbidity risk (Kac et al, 2021). Mrs. AK has a WC of 4ft, which is regarded as extremely high. Mrs. AK’s dietary assessment (I) revealed that for breakfast, she drinks water with lemon, has coffee with sandwiches, toast with butter and cheese, or a fried egg in pita bread with cheese. For lunch, she might eat sandwiches, snacks, cookies, and nuts.
For dinner, she could have already prepared pizza, potatoes, fried chicken in pita, fried eggs with bacon, and macaroni. She enjoys citrus fruits and avoids prunes, liver, and milk in its pure form, preferring to drink it with coffee.
A 24-hour dietary recall revealed that she had one cup of coffee, sugar, and milk, as well as four slices of toast with butter and melted cheese. Snack on a small piece of cake with a glass of cherry juice. Dinner pizza: four slices, sweet tea, and one nugget.
Mrs. AK (II)’s physical activity assessment revealed that she rarely leaves her home. Her physical activity is infrequent, occurring only when she is outside with her children. Mrs. AK was given a pedometer for a week to determine how much she moved, and the outcomes that followed were gathered: day 1, 1856 steps, day 2, 2849 steps, day 3, 1985 steps, day 4, 1875 steps, day 5, 1653 steps, day 6, 3987 steps, and day 7, 2876 steps.
Mrs. AK gets up at 8 a.m. every weekday and works until 4 p.m. Sometimes she works night shifts from 10 p.m. to 3 a.m. She does not take short naps throughout the day. She might wake up several times during the night to feed her youngest child.
Mrs. AK puts her children to bed at 8 p.m. and then reads a book until 10 or 11 p.m. After a night shift, she may fall asleep at 4 or 5 a.m. and wake up at 9 a.m. The individual reported daytime sleepiness and snoring while sleeping. After completing the PSQI, the results revealed a score of 15, indicating relatively poor sleep quality. Mrs. AK claims that she struggles to pay attention to her children while working and that she never has enough time to relax (Joseph et al., 2023). Mrs. AK’s PSS was 23, indicating moderate perceived stress.
Background on the Specific Unhealthy Lifestyle Choice
Mrs. AK was overweight during her adolescence. Her weight varied from 160 lb to 143 lb. She had 132 lb before becoming pregnant, but her weight increased to 165 lb during the pregnancy. After a year, she was able to lose 11 lb through exercise and diet. After that, she began gaining weight again, and by her second pregnancy, she weighed 171 lb. During her second pregnancy, she gained an additional 17 lb and was regarded as at risk for obesity and pregnancy diabetes, but no tests revealed diabetes. After giving birth, she lost 17 lb but still weighed a lot.
She tried to diet several times, but her family’s recent physical and psychological difficulties caused her to actively gain weight. Her weight of 213 lb has remained stable for nearly two years, with a +-2 lb or 4 lb gain. After childbirth, she also has a sagging stomach and extra volume in her breasts, which prevents her from sleeping and puts additional strain on her back (Hanley et al., 2023). Mrs. AK complains that she cannot sleep on her stomach because of this. She did not seek medical help to lose weight and has not followed any diets during this time. Mrs. AK gained 4 lb during the assessment as a result of anxiety and stress about her children and husband.
Management
Mrs. AK should be given an achievable weight loss goal of 198 lbs. The first step is to determine the level of intervention based on BMI, WC, and number of comorbidities; Mrs. AK has a level 3, so she should be advised to diet, exercise, and consider medication. Because she does not want to lose weight, a modest weight reduction should be initiated, which may lead to her wanting to lose an additional 11 lbs.
The treatment plan will include diet modification (healthy snacks, no bread, more greens, and olive oil), an individualized approach to physical activity (taking the stairs rather than the elevator, walking 20 minutes per week), sleep modification (sleeping without the baby, considering not feeding at night), and stress management (meditation, yoga and communication with psychologist) (Hanley et al., 2023). If the patient fails to lose at least 2 lb by the end of the month, medication will be discussed.
References
Hanley, S.J., Varley, I., Sale, C., Elliott-Sale K. J. (2023). Experiences of physical activity, healthy eating and quality of life during and following pregnancy in overweight and obese postpartum women. Matern Child Health J 27, pp. 1968–1980.
Joseph P.L., Gonçalves C., Fleary S.A. (2023). Psychosocial correlates in patterns of adolescent emotional eating and dietary consumption. PLoS ONE 18(5).
Kac, G., Carilho, T. R., Rasmussen, K. M., Reichenheim, M. E., Farias, D. R., & Hutcheon, J. A. (2021). Gestational weight gain charts: results from the Brazilian Maternal and Child Nutrition Consortium. The American journal of clinical nutrition, 113(5), 1351-1360.
Wu T, Tan X, Li Y, Liang Y, Fan J. (2024). The relationship between occupational fatigue and well-being: The moderating effect of unhealthy eating behaviour. Behavioral Sciences 14(1):32.
