With a new year comes New Year's resolutions, and one of the most popular is the desire to lose weight.
Despite this, according to the most recent National Health and Nutrition Examination Survey (NHANES), 18.5% of children and nearly 40% of adults are considered obese, the highest rates ever documented by NHANES.
That's 93 million adults in the U.S. who struggle with obesity and are cared for by health professionals and nurses like you.
Battling obesity is not a new concern in healthcare. Obesity is defined as having a body mass index (BMI) greater than 30-a number calculated based on a patient's height and weight, which can vary between males and females.
The obesity epidemic has many effects on the entire healthcare system, including:
1. Patient health
Obesity has a range of impacts on a patient's body. The increased pressure from the accumulation of fatty tissue causes pressure on internal organs leading to conditions such as:
- high blood pressure
- type 2 diabetes
- esophagitis
- chronic obstructive pulmonary disease (COPD)
- sleep apnea
- varicose veins
- stress incontinence
- lymphedema
- hernias.
Venous insufficiency and poor circulation also leaves patient more susceptible to infection and skin breakdown after surgery.
2. Staff safety
In order to prevent skin breakdown in an immobile obese patient, most staff follow a schedule of changing the patient's position every two to four hours. This may require additional staff depending on the patient's weight. If no one else is available, a staff member may put their own physical well-being at risk while re-positioning an obese patient.
3. Financial impact
Obesity affects the pharmacokinetics of the body, which can lead to patients requiring more frequent administration or higher doses of medication, as well as more frequent care and vital sign monitoring by staff.
There also may be non-reimbursable treatment. Due to the additional pressure the accumulation of fatty tissue creates, the obese patient is more at risk for infection and dehiscence of surgical wounds. In some cases, Centers for Medicare Services (CMS) standards call for hospitals not to be reimbursed for care related to conditions such as surgical site infections. Obesity also creates impaired mobility, leading to an increased risk for falling. CMS will not reimburse a hospital for patient fall complications and skin breakdown that is acquired while the patient is hospitalized.
Hospitals may have to consider ordering new bariatric equipment including hospital beds, wheelchairs, bedside commodes, and walkers to accommodate obese patients. Hospitals that are seeing increased numbers of obese patients are turning to design experts to help create new doorways and hallways to accommodate the growing physical size of their patients.
The role of nurses
Nurses and nurse practitioners have a significant opportunity to impact the obesity epidemic. Nurses act as role models by educating patients and families on nutrition, the health care system, and obesity-related illnesses. NPs can act as personalized counselors by helping patients identify their health goals and develop plans to achieve them. They are also able to work with individuals on the health challenges they face.
A healthy diet is a key component to reducing weight and overall health. Nurses can work closely with patients to provide education on healthier choices. All forms of exercise complement a healthy diet in maintaining a weight that minimizes adverse outcomes. The Center for Disease Control (CDC) recommends regular physical activity on most days of the week and stresses consistency as the best means for maintaining a healthy weight.
These personal interactions and individualized care can mean a lot to patients and their families. Nurses also know the risks that stem from obesity and can educate patients on the more scientific elements of this health issue. By explaining how obesity can turn into diabetes, heart disease, and even cancer, patients are better able to see benefits of making healthier choices.
