Obesity Case Study 8
ObesityCase Study 8
ObesityCase Study 8
A29 year old Caucasian woman who reports to your office for her yearlywell woman exam. Her BMI at the visit today is 36. She states she hasbeen overweight since having her first baby (4 years ago) and isfrustrated that she is “this heavy". Her past surgical andmedical history is noncontributory but she reports a family historyof hypertension. She would like you to prescribe her “pills"so she can lose weight quickly.
Obesityis a major concern especially with the health risks that it posesincluding cardiovascular complications among others. Considering thepatient has a family history of hypertension, it is essential tocontrol her weight to avoid developing the condition as well asothers. A BMI above thirty is an indication of obesity. The client’sBMI is 36 thus indicating the need for critical management to helpher lose weight (Ogden, Carroll, & Flegal 2014). However, theweight loss process mainly depends on the client’s motivation,adherence, and cooperation in working with the caregiver for bestresults. Hence health education is essential in ensuring that theclient understands the condition, risks, and the management processto ensure cooperation with the therapy.
Thefirst step in the management is explaining to the client her BNIresults and what they indicate. It is necessary to educate thepatient on weight gain and BMI ranges. Explain on obesity, thecauses, the risks it puts the patient in, the complications that onecan develop and the management process. Afterward, it is vital toknow what the client is willing to do to lose weight as well as hersource of motivation. Ensure that the client is ready to adhere tothe available therapies in the management of obesity (Gaillard et al.2013). Once it is clear that the client is willing and motivated tostart the weight loss journey, the caregiver can proceed.
Managementof obesity begins with thorough lifestyle changes, this comprises ofdiet, behavior change, and physical activity among others. Since thepatient’s BMI is 36, the management considerations include surgery,pharmacotherapy, dieting, behavior alteration, and exercise(Landsberg et al. 2013). Explain to the patient the treatment optionsavailable. With the high BMI, the patient’s request for weight loss“pills” cannot be the only therapy used. Instead, it is essentialto combine pharmacotherapy and other management modalities. Take thepatient’s random blood sugar and vital signs to ensure that thereare no underlying conditions. Ensure that the history iscomprehensive enough to establish any risks or complications thatcould arise (Ogden, Carroll, & Flegal 2014).
Administerorlistat 120mg that the patient should take orally, three times aday, during meals or one hour later. Explain to the patient thatorlistat inhibits gastric and pancreatic lipases thus preventing thehydrolyzing of triglycerides into fatty acids thus reducing depositsinto the body as the triglycerides get eliminated from the body. Thenext step would be to recommend behavior change, physical activity,and diet. Establish weight loss goals with the client so that theyare able to put in an effort towards losing a certain amount ofweight after a specified period. The goals are also effective inmotivating the client through the whole process. Once the goals areestablished, it is necessary to narrow down to the therapies needed(Landsberg et al. 2013).
Reducedportion size diets are effective in weight loss management as well asminimizing the chances of complications such as vitamin deficiency,cholelithiasis, and starvation ketosis. Portion regulation isachievable through weight loss programs that the caregiver can givethe patient to follow. Alternatively, based on the client’s dailydietary intake, she can work with the nurse in coming up with a planthat best suits her in terms of preference and cost-effectiveness.Advise the client to avoid consumption of alcohol, sodas, processedfruit juices, and other sweets as they are high-calorie products withno nutritional benefits. Recommend intake of a lot of water that isat least two liters in a day. Educate the patient on the significanceof taking whole grain foods as they have fewer calories and thusessential in supporting weight loss (Gaillard et al. 2013).
Exerciseand behavioral changes are also vital to losing weight. Advise theclient to take part in various forms of exercises. Refer her to aphysical fitness trainer that she can work with towards cutting offsome weight and staying fit. Recommend light exercises such aswalking instead of taking a bus over short distances and using thestairs instead of elevators. With regards to behavior, the clientshould strictly adhere to the weight loss therapy for best results.Recommend the avoidance of midnight snacking and consumption of junkfood (Landsberg et al 2013). Getting enough rest is also critical toattaining a fit and healthy body therefore, the patient should alsohave sufficient sleep.
Therefore,having established a weight loss plan with the client, ensure thatthey are comfortable with the program and willing to adhere to it forbest results. Follow-up care is essential to check on the client’sprogress. Advise her to seek medical help in case of anycomplications such as breathlessness, persistent headaches andfatigability (Gaillard et al. 2013). Encourage the client to stick tothe plan without losing hope as it is possible to lose weight as longshe is determined. Allow her to ask any questions and raise concerns.Recommend follow-up care after one month to check on theeffectiveness of the medicine as well as other programs andcompliance to establish whether the client should continue with thetherapies (Ogden, Carroll, & Flegal 2014).
Gaillard,R., Durmuş, B., Hofman, A., Mackenbach, J. P., Steegers, E. A., &Jaddoe, V. W. (2013). Risk factors and outcomes of maternal obesityand excessive weight gain during pregnancy. Obesity, 21(5),1046-1055.
Landsberg,L., Aronne, L. J., Beilin, L. J., Burke, V., Igel, L. I.,Lloyd‐Jones,D., & Sowers, J. (2013). Obesity‐relatedhypertension: Pathogenesis, cardiovascular risk, and treatment—Aposition paper of the Obesity Society and the American Society ofHypertension. Obesity, 21(1),8-24.
Ogden,C. L., Carroll, M. D., & Flegal, K. M. (2014). Prevalence ofobesity in the United States. Jama, 312(2),189-190.
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