The role of the nurse practitioner in obesity management

The role of the nurse practitioner in obesity management.

Obesity is an increasing, global public health issue. Patients with obesity are at major risk for developing a range of comorbid conditions, including cardiovascular disease (CVD), gastrointestinal disorders, type 2 diabetes (T2D), joint and muscular disorders, respiratory problems, and psychological issues, which may significantly affect their daily lives as well as increasing mortality risks. Obesity-associated conditions are manifold; however, even modest weight reduction may enable patients to reduce their risk for CVD, diabetes, obstructive sleep apnea (OSA), and hypertension among many other comorbidities.

A relatively small and simple reduction in weight, for example, of around 5%, can improve patient outcomes and may act as a catalyst for further change, with sustainable weight loss achieved through a series of incremental weight loss steps. In facilitating the process of losing weight for patients, nurse practitioners play an essential role. Through assessing the patient’s risk, establishing realistic weight-loss targets, providing motivation and support, and supplying patients with the necessary knowledge and treatment tools to help achieve weight loss, followed by tools for structured lifestyle support to maintain weight loss, the nurse practitioner is ideally positioned to help patients achieve their weight-loss – and overall health – targets.

The initial and ongoing interactions between patient and nurse practitioner are keys for the determination of an effective approach and implementation of a weight loss program and subsequent weight maintenance. The initial interaction can be instigated by either the nurse practitioner or the patient and once the decision has been made to manage the patient’s weight, the evaluation includes a risk assessment, a discussion about the patient’s weight, and treatment goal recommendations. Across this process, it may be advantageous to approach this using objective data and language that is motivational and/or non-judgemental. Patients may struggle with motivation, and therefore, ongoing discussions around the health benefits and improvements to quality of life as a result of weight loss may be required. It may be valuable to allocate personalized benefits to the weight loss such as playing with children/grandchildren. Treatment approaches encompass nonpharmacological and pharmacological strategies; however, it is important to remember that any pharmacological agent used should be used as an adjunct to nutritional and physical activity strategies.

Nurse practitioners play a major role in helping patients achieve weight loss through all aspects of the process including assessment, support, motivation, goal-setting, management, and treatment. With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in the weight-management strategies deployed in clinical practice.

Slovníček
nurse practitioner – sestra s rozšířenou způsobilostí
issue – problém, záležitost, otázka
joint – kloubní; kloub
to affect – ovlivnit; postihnout; zasáhnout, zachvátit; poškodit
manifold – četný, rozličný, rozmanitý; mnohostranný
even – dokonce, dokonce i
modest – mírný; skrovný; skromný; umírněný
weight – váhový; váha, hmotnost
further – další; bližší
to facilitate – usnadnit, ulehčit; umožnit
through – skrze; přes; během; díky
target – cíl, plán; terč
achieve – dosáhnout; uskutečnit, dokončit
overall – celkový; globální
approach – přístup, metoda; přistupovat; blížit se
to instigate – podněcovat; nabádat, navádět
advantageous – výhodný
non-judgemental – neodsuzující
to struggle – bojovat, usilovat; mořit se; protloukat se
ongoing – pokračující; současný, aktuální
to allocate – určit, stanovit; přidělit; rozdělit
to encompass – zahrnovat, zahrnout; obklopit
adjunct – doplněk, dodatek; přídavek
goal-setting – stanovení cílů
in-depth – podrobný, hloubkový, důkladný
to deploy – rozestavit, rozmístit, nasadit

 

Source: FRUH S. M. Risk factors, complications, and strategies for sustainable long-term weight management. J Am Assoc Nurse Pract 2017; 29(S1): S3–S14. doi: 10.1002/2327-6924.12510 (kráceno)

 

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