ObesityIndia S. Sharp, BSN, RN

November 02, 2013

Objectives Provide knowledge of the pathophysiology,

epidemiology, symptoms, & non-pharmacological treatments

Obesity Obesity is a label for ranges of weight that are greater than

what is considered healthy for a given height. Obesity is having an excessive amount of body fat. It

increases risk of disease and health problems such as Type 2 Diabetes, Coronary artery disease (CAD), hypertension, stroke, gallbladder disease, cancer, osteoarthritis, and hyperlipidemia. Weight loss can reduce these risks by 10%.

Obesity is a chronic relapsing disease needing management in other disease such as diabetes and hypertension with physical, psychological, and social consequences.

Abdominal obesity, rather than body fat, can be a useful indicator of cardiovascular and cancer related outcomes. Measuring abdominal obesity includes waist circumference, hip circumference, and waist-to-hip ratio.

Epidemiology More than one-third (35.7%) of the adults

in the United States are obese in 2009-2010.

Obesity effects all groups in society, irrespective of age, sex, race, ethnicity, socioeconomic status, educational level, and geographic group.

Adults over the age of 60 were more likely to be obese than younger adults.

National Prevalence

PathophysiologyHypertophic versus Hypercellular

obesity Hypertrophic obesity usually starts in

adulthood and responds to weight reduction measures.

Hypercellulary obesity typically occurs in persons who develop obesity in childhood or adolescence. Hypercellular obesity may find it difficult to lose weight without surgical intervention.

Adult Obesity by BMIClassification of Adult Obesity

by BMIBMI (kg/m2)

Underweight <18.5Normal 18.5-24.9Overweight (Pre-obese) 25.0-29.9Obesity 30.0-34.9Severely Obese >40.0Morbid Obese 40.0-49.9Super Obese >50.0Super-Super Obese (SSO) > 60.0

Etiology Obesity is the imbalance between energy

intake (Eating too much) and energy output (not exercising or too little).

Predisposing Factors

Metabolic factors (Leptin levels)

Genetic factors (Family history of obesity)

Level of activity (Lack of exercise/sedentary lifestyle, Television (TV), computer, and hand-held game use more than 3 hours/day, and increase leisure time)

Endocrine factors

Race, sex, and age factors

Ethnic and cultural factors (Ethic background: African American, Hispanic)

Socioeconomic status

Smoking Cessation

Pregnancy and menopause

Psychological factors

History of gestational diabetes

Lactation history in mothers

Dietary habits (consuming too many calories/high fat diet, Poor dietary choices, and/or Readily available food sources, especially fast foods)

Predisposing Factors

Common Complaints/Signs and Symptoms

Common Complaints/Signs and Symptoms

Difficulty performing routine daily activities, including hygiene.

Inability or lack of interest in exercising

Shortness of breath and/or asthma exacerbation

Incontinence

Obstructive Sleep Apnea (OSA)

Infertility/polycystic ovarian syndrome

Symptoms of cholelithiasis (heartburn, indigestion, nausea, vomiting, fatigue, headaches, light or chalky colored stool, and dark urine)

Hypertension

Treatment Non-Medical

Diet changes Low calorie Increase fruits and vegetables Eliminate alcohol and sugar-containing beverages Reduce intake of sweets and sugars Reduce fat intake Reduce portion sizes Increase water intake

Exercise (Increase activity as tolerated) Encourage getting up for 10 minutes each hour Start off with just walking as tolerated

Specialist

Dietitian Psychologist consultation

Discussion