Obesity: A Growing Health Issue in the US - Essay Sample

Introduction

Obesity is one of the health issues that have continued to affect the lifestyle of people in profound ways. Several statistics in the United States have indicated that the majority of the United States citizens are obese. According to the center for disease control and prevention, the prevalence of obesity stood at 42.4% between 2017 and 2018 (Center for Disease Control and Prevention [CDC], 2020). It is also reported that there has been an increasing trend since 1999. Obesity has been related to health conditions such as diabetes, certain cancers, among other health complications. The risks associated with diabetes can be prevented through changing lifestyle habits such as the incorporation of exercise as a part of a healthy lifestyle. The best practice for the control of obesity looks at some of the ways of overcoming the health problem by analyzing the disease pathophysiology, standard of practice. Patient's treatment outcomes and the implementation of the best prevention plan to alleviate the negative symptoms of the disease.

Pathophysiology of Obesity

The pathogenesis of obesity is considered a complex process with both environmental and genetic composition seen as having an impact on obesity. Excess fat stored in the body is required during the nutritionally deprived state. However, it the event of adequate food, normal fat storage results in the abundance storage of fat hence resulting in diabetes. The storage of fatty acids within adipocytes prevents the body against fatty acid toxicity. Excess storage of fats that leads to obesity results in excessive fatty acids out of increased lipolysis. The excess fatty acids stimulate lip toxicity. The latter process affects the adipose and non-adipose tissues leading health problems resulting from the effects of the excessive fatty acids to organs such as the liver and pancreas.

Fats constitutes about between 21-37% of the body weight (CDC, 2020). In cases of obese more calories are consumed than used, with no reduction in appetite to enhance a balance between calories consumed and expended. The amount of adipose tissue is regulated through neural signals relayed to the brain, and as such, the failure by the fat cell to send signals prevents the brain from acting in the appropriate way, thus causing obesity. There needs to be an effective system control between the sensors of energy stores and the brain for effective determination of food expenditure and intake (Center for Disease Control and Prevention [CDC], 2019). Food intake is regulated by multiple processes such as gustatory factors, the action of gastrointestinal hormones, among others. All of the above processes are performed by hormones. One of the significant hormones is insulin, which stimulates the release of leptin from fat cells that affects food intake. Some of the hormones such as chronic ghrelin increase food intake, while at the same time reducing food expenditure.

The amount of intake also contributes to obesity. Obesity can result from the daily excess of energy consumption, which keeps on increased to maintain the increased weight. However, it also depends on the food eaten. For instance, fats have more calories than either carbohydrates or proteins. Here, increasing the intake of such food affects the energy balance.

Obesity is measured using the body mass index that factors in an individual's weight and height. The BMI index is used to evaluate the amount of fat that a person's body. A BMI of 18.5-24.9 is termed as normal, 25.0-29.0 is overweight while above 30.0 is considered obese (CDC, 2020). However, obesity is further subdivided into classes which help in determining the severity of comorbidity.

Standard of Practice

There are various guidelines that are used in the management of obesity. The standard of care for obesity that continues to be used in various parts of the world to control obesity was developed by the American Association of Clinical Endocrinologists, after declaring that obesity is a disease. The issued guidelines focus on the treatment of obesity by not only prioritizing weight loss but also focus on improving the health standards of those living with the disease. The guidelines are conscious of the varied nature of the pathophysiology of obesity by considering both the genetic, environmental, and behavioral elements. The standard of practice is to minimize the confusion in the care and treatment of obesity. The guidelines acknowledge the need of not basing clinical assessment for obesity of BMI but consider other health factors that may also suggest that a patient is obese.

The guidelines provide both pharmacological steps that can be taken to control diabetes but also considers other areas such as non-medical steps that can be employed to control the disease. It, therefore, imperative to evaluate the standard of practice guidelines on the use of medication to control diabetes and general clinical guidelines.

Medication for Obesity

The 2016 guidelines propose the use of medication in various situations. Firstly, they recommend the use of medication for the control of chronic obesity, monitoring patient's weight progress as well as for opting for weight loss or weight-neutral medication in addressing health conditions such as depression and other mental conditions (Wadden & Bray, 2018). There are five medications that have been approved by the food and drugs association that can be used for the treatment of obesity. The first medication is the Orlistat that is approved for adults and children above twelve years. The drug works on patients' gut and minimizes the amount of fat that the body absorbs from food intake. Some of the common side effects associated with the drug are stomach pain, diarrhea, and excess gas. One of the severe health effects associated with the drug is liver injury (CDC, 2020). A recommendation is normally issued for the drug to be taken alongside a multivitamin pill to give the body minerals that can be absorbed from the food that patients eat.

The second drug is Lorcaserin, prescribed for adults, and works by altering the serotonin receptors of the brain, making a person feel full after a small amount of food (Wadden & Bray, 2018). However, the drug was recently withdrawn from the US market after its linkage to the prevalence of cancers. The third drug is Phentermine topiramate, which is prescribed for adults. The drug works by reducing appetite and makes a person feel less hungry or full upon taking a small amount of food. Some of the side effects that have been associated with the drug include constipation, tingling of hands and feet, problems sleeping. It is not recommended for patients with underlying diseases such as glaucoma. To reduce severe health risks, patients are advised to talk to their doctors in case they have had a heart attack, kidney disease, or heart problems. It can also lead to birth problems, and therefore it is advisable that it should not be taken by pregnant and breastfeeding women.

The fourth drug is Contrive prescribed for adult's works by helping people avoid depression and smoking (Skinner et al., 2018). Side effects associated with the drug include constipation diarrhea, insomnia, liver damage, vomiting, and blood pressure, among others. As such, it is not advisable for persons with seizure and unmanaged blood pressure and persons withdrawing from drugs as well as those with suicidal ideation. The last drug is Saxenda, which is prescribed for adults and works by making someone feel less hungry very fast. Side effects include nausea, diarrhea, constipation, and abdominal pains. Several health side effects include the possible development of pancreatitis and some type of tumors in animals.

University of Virginia Health System is one of the hospitals in Charlottesville, Virginia, that has been at the forefront of caring for obese patients (Wadden & Bray, 2018). The hospital has been majoring in the treatment of hypertension in obese patients through conducting surgeries. However, the hospital also adheres to the guidelines by the American Association of Clinical Endocrinologists and American College of Endocrinology on the approved medication for the medical management of obesity. The latest development by the hospital has been researching the ability to treat hypertension in obese people using the right compounds. The research by the hospital is a bold move in the management of obese, which proves that by focusing on research, there advanced medication that helps address numerous health concerns for people with diabetes. The success in the use of surgery for the treatment of hypertension in obese patients shows a great move by the hospital that could also be fruitful in their recent research.

Clinical Guidelines

Assessment

Obese patients that have not been diagnosed with will be assessed using the body mass index in order to ascertain whether they are obese. Patients who are obese will have a body mass index, which ranges from 30-39.9 (CDC, 2020) . The weight circumference of people who are obese is normally bigger than their hips. Obesity focused history will also be conducted to check whether the patient has had problems with body weight. This will also include an examination of other factors such as checking whether they have enlarged thyroid or thyroid bruit, among others. The physical examination will include a check for various areas of the skin for evidence of obesity.

Diagnosis

The guidelines acknowledge that obese patients should be clinically evaluated for other health-related complications because the body mass index cannot show the impact of the excess adipose on the patents. As such, clinical trials can as well be conducted to check for other health risks such as diabetes and high blood pressure. This should also include screening for cardiovascular diseases such as hypertension.

Patient Education

Patients diagnosed with obesity will have to undergo certain changes for the purpose of controlling the disease. One of the changes that patients will be required to undertake is changing lifestyle changes, for instance, change of diet and engaging exercise. Patient education is vital because patients will be required to be part of the treatment plans in order to avoid practices that negatively affect treatment outcomes. Patients will have to be encouraged on the need to undergo other tests and not only having their body mass index checked (CDC, 2019). The intervention in addressing obesity differs, and not every patient will be subjected to exercise. Thus, it is necessary that patients are made aware of different steps that may be taken depending on their condition. Patients will also be advised on the need to change their diets so that they are able to monitor the levels of fats in the body (Wadden & Bray, 2018). Diet suggestions may include eliminating foods rich in fat, carbohydrates, highly processed, and low in fiber. A diet plan should be established for an individual patient such as specific grams of protein and carbohydrates, increased fruits, reduction of daily caloric intake, and vegetables based on their current body weight and their total body requirements. Generally, patients can be referred to a Registered Dietician to discuss strategies that are effective for meeting weight loss expectations and goals.

University of Virginia Health System continues to dedicate more resources to the management of obesity. The operations of the hospital in the treatment and care for patients with obesity are in accordance with AACE guidelines (Wadden & Bray, 2018). The University of Virginia Health System uses the body mass index as well as other forms of physical assessment to diagnose people who are either obese or overweight. The use of medications and non-medical approaches...