Obesity

Bariatric surgery: an effective quick fix to prevent the complications of morbid obesity or prelude to long-term problems?

Avoiding weight gain after stopping smoking

Stopping smoking is associated with considerable health benefits and large numbers of smokers want to quit. However, concern about weight gain is one of the reasons people often give for not being able to quit smoking. It often reinforces the decision to continue smoking, particularly in women and young people who may mistakenly believe that smoking is an effective way to control their weight. Even if an individual successfully quits smoking, weight gain can often be the factor that causes relapse. What can we do to help?

Helping your patients to manage their weight: a behavioural approach

The health risks of obesity are only too obvious but, despite this, its prevalence continues to increase. It is a leading cause of both physical and psychological ill health, and is notoriously difficult to treat. For this reason, the National Institute for Health and Clinical Excellence (NICE) emphasises the importance of preventing obesity and has produced guidelines on the most effective approaches. Many health professionals wish to support their patients with weight loss, but research has shown that they do not always feel well equipped to do this. In this article we review the importance of a behavioural approach in managing overweight and obesity and provide practical advice on how to help overweight patients achieve sustainable behavioural change.

Helping patients with diabetes to win the battle to control their weight

Many people with type 2 diabetes are overweight or obese at diagnosis and continue to struggle to control their weight. This article looks at why people with diabetes find weight control more of a challenge than the rest of us and how practice nurses can help patients to remain positive, particularly when starting insulin to optimise blood glucose control.

What factors influence what we choose to eat and how can we improve choices?

Obesity is, quite literally, the big health problem of the 21st century, with rapidly increasing rates in both adults and children. In this article we explore why obesity is such a challenge and the role of primary healthcare professionals in addressing the problem. We try to unravel the wide range of factors that cause obesity before focusing on why people eat what they do and how we can help patients to review their eating habits, introduce changes to eat more healthily and then sustain those changes.

Helping patients to lose weight: best practice for primary care

Obesity poses a major threat to the nation’s health and a national strategy is required to stem the rising prevalence, decrease the morbidity and mortality from associated conditions, and reduce pressure on the National Health Service. Primary healthcare staff will be at the centre of any such approach. Practice nurse-led lifestyle clinics have demonstrated that clinically beneficial weight loss can be achieved with a structured approach to weight management. In this article, we explore the impact of obesity and best practice strategies to help patients lose weight.

Optimising the prevention and management of obesity: putting NICE guidance into practice

Obesity is a rapidly growing problem in the UK. Department of Health statistics show that the prevalence of obesity in children under 11 years of age rose from 9.9% in 1995 to 13.7% in 2003, and in adults obesity prevalence has trebled since the 1980s, with more than 50%, (almost 24 million adults), now being classed as overweight or obese. In the article, we review the latest guidance from the National Institute for Health and Clinical Excellence (NICE) on how to prevent and manage obesity in practice.

Mending the growing problem of childhood obesity

There is no argument about the fact that childhood obesity in the UK is a serious problem. According to the Department of Health, childhood obesity affected 14.3% of 2-10 year olds in England in 2004. This was almost 5% more compared to the 1995 figures, and the estimated prevalence for 2010 is 20% if nothing is done, meaning that one million children will be obese. What can we do to reverse this growing epidemic of childhood obesity?

Body Mass Index (BMI) Or Waist-Hip Ratio?

The association between body mass index (BMI) and mortality from both cardiovascular disease (CVD) and coronary heart disease (CHD) is well accepted. Individuals with high BMIs are also at increased risk of developing other conditions such as sleep apnoea, osteoarthritis, female infertility, varicose veins, gastro-oesophageal reflux and stress incontinence. BMI has been the gold standard for predicting health by measuring body weight in relation to height. However, although BMI may be helpful in estimating overall obesity, it is becoming increasingly apparent that waist-hip ratio, which estimates central obesity, is a more accurate predictor of the risk of health problems generally and CVD in particular.

Apples and Pears: Targeting Abdominal Obesity

Healthcare professionals spend a great deal of their time screening for, and treating, silent killer diseases such as diabetes, hypertension and hyperlipidaemia but often ignore the primary cause of these conditions, which is often – quite literally – staring them in the face. Obesity can be seen without the need to use any fancy gadgets – we simply need to use our eyes each time we see a patient. There are essentially two main body shapes – apples and pears – each associated with different distributions of body fat. Pearshaped people carry most of their excess fat around the hips, buttocks and thighs. Apples carry most of their excess body fat around the middle; this is known as central obesity and is much riskier for diabetes and cardiovascular disease. In this article we review why central obesity matters, how to measure it and management strategies.

Facing up to the Challenge of Childhood Obesity

In a recent report on childhood obesity, the British Medical Association described the significant increase in levels of childhood obesity as a ’cause for great concern’ and stated that healthcare professionals have a pivotal role to play in tackling this epidemic. It is estimated that there are now approximately 1 million obese children under the age of 16 in the UK and numbers are increasing annually. In this article, we review the impact of this growing epidemic, the underlying causes and how healthcare professionals can help.

Maintaining motivation: the long haul of weight loss

There is no doubt about it, achieving and maintaining weight loss long term is a great challenge. Primary care nurses have a significant role in motivating patients to adopt a healthy lifestyle and to persevere with weight management programmes. In the last issue of BJPCN we looked at how to raise the tricky subject of obesity with patients. This time, we continue the issue by exploring how practice nurses ensure a positive working relationship with their patients with weight problems and encourage them as they tackle the long-term issue of obesity.

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