Making Best Practice, Every Day Practice
Recognition of the diverse areas of the brain and multiple neurochemicals and hormones involved in regulation of appetite, satiety and metabolism helps to explain why obesity treatment needs to be individualised and is more complicated that merely instructing people who are living with obesity to eat less and move more. On the contrary, it requires […]
Obesity is estimated to be responsible for more than 30,000 deaths each year, reducing lifespan by an average of nine years. The links between obesity, diabetes and cardiovascular disease are well documented, but overweight and obesity also causes 6% of cancers in the UK. These figures have resulted in warnings that obesity is the new smoking when it comes to risks to health and longevity. So the problem is clear. The challenge is to put into action what works.
This useful wall chart shows how just 5-10% weight loss improves important markers of cardiovascular health, including lipids, blood pressure, diabetes risk and inflammation.
This case study presents an everyday clinical situation for you to review with guidance from an expert in the field.
A new NICE guideline provides valuable information on the assessment and management of non-alcoholic fatty liver disease (NAFLD) caused by a build-up of fat in the liver.
Practice nurses are in the frontline of the fight against obesity, yet they face a moving target. Around 10 years ago, the ‘centre ground’ of the battle comprised patients with around 10 kg to lose; today, it is 20 kg. This has profound implications for weight management and a range of related conditions, but recent research is highlighting new solutions for this group of patients.
Excess body weight is associated with a higher risk of cardiovascular disease, type 2 diabetes, cancer and a range of other debilitating health conditions, and is the third leading cause of death in high-income countries like the UK. Since practice nurses may have long-term, regular contact with patients, they may be well placed to motivate and support individuals in losing weight. It can, however, be difficult for nurses to find the right words to discuss this very sensitive subject with patients.
At least 22% of men and women in the UK are obese. All health professionals need to be skilled in the initial management of obesity. Behaviour change is core to any strategy, as are brief interventions that incorporate advice on physical activity and healthy eating. Training in primary care needs greater emphasis for the future management of obesity.
Most of the UK population – including the patients we see every day – are now more likely to have a weight problem than be of a healthy weight. Instead of focusing our efforts, and valuable resources, on managing the consequences of obesity, we should tackle its causes and appropriately manage patients motivated to address their unhealthy weight.
In the UK about half of women of reproductive age are either overweight or obese. Obesity is known to adversely affect female fertility, as well as the health of mothers and their children. But even modest weight loss can restore fertility and improve a woman’s chances of a successful pregnancy.
Weight loss (bariatric) surgery is becoming increasingly common as the obesity epidemic continues to flourish, and recent NICE guidelines have supported this approach. In this article, we review the procedures used in bariatric surgery, the impact on patients’ cardiovascular risk and type 2 diabetes, what the guidelines recommend and the long-term care of patients who have undergone this type of surgery.
Central obesity remains a big issue in the UK. The accumulation of adipose tissue in the abdominal region is a particular risk factor for chronic disease and mortality.1 In 2008, 39% of adults in England had a waist circumference indicative of central obesity (above 88 cm for women and 102 cm for men).2,3 Two proven effective dietary strategies for reducing waist circumference are the inclusion of whole grain foods in the diet and the avoidance of meal skipping.4 Advice to start the day with whole grain breakfast cereal and/or whole grain bread combines these two strategies in one simple and feasible practical message.
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