Week 5 Overweight & Eating Disorders, Semester 3, 2023-2024 PDF

BSN 111 Applied Nutrition for Nurses Overweight and Eating Disorders 2023 / 2024 Semester 3 – Week 5 By: Firas Qatouni, RN., M.Ed., 6/23/2024 1 ...

BSN 111 Applied Nutrition for Nurses Overweight and Eating Disorders 2023 / 2024 Semester 3 – Week 5 By: Firas Qatouni, RN., M.Ed., 6/23/2024 1  Learning Outcomes By the end of the lecture, the students will be able to: Formulating nursing nutritional interventions for overweight clients and those with eating disorders using assessment parameters Analyse risk factors for the development of overweight and eating disorders Formulate a treatment plan using lifestyle management for overweight Examine nutritional concerns following bariatric surgery Discuss clinical parameters and treatment of the types of eating disorder 2  Overweight and Obesity Greatest perceived health concern among Emirati women 2017  Overweight and Obesity Overweight and obesity is the accumulation of excess body fat. BMI greater or equal to 25 is considered overweight Abdominal obesity- defined by waist circumference and waist-to-hip ratio Abdominal obesity is a risk factor for cardiovascular disease 4 Waist to Hip Ratio 5 Waist to Hip Ratio Meaning 6  Causes of Overweight and Obesity Biology  Metabolic disorders such as hypothyroid disease  Hormones that affect appetite and satiety. Environment  Increased consumption of calories and decreased expenditure of energy  Calorie dense foods  Increased portions 7  Causes of Overweight and Obesity Technology &  Decreased energy expenditure sedentary lifestyle  Less physical labor and lack of exercise Food insecurity and Intake of low cost, high fat foods poverty Medication  Some medications increase appetite or reduce metabolic rate  Antipsychotics, antidepressants, mood stabilisers, anticonvulsants and corticosteroids 8  Health Risks of Obesity 1. Infertility 2. Congenital abnormality 3. Certain cancers 4. Degenerative joint disease 5. Gastroesophageal reflux 6. Kidney stones 7. Gall stones 8. Fatty liver disease 9 Health Risks of Obesity 10  Obesity in UAE According to the National Health Survey, adult obesity in the UAE stands at 27.8 % in 2019.Jul 10, 2019 UAE: Nearly 70 per cent Emirati male adults under 30 'are obese' https://gulfnews.com/uae/health/uae-nearly-70-per-cent- emirati-male-adults-under-30-are-obese-1.65102616 https://www.khaleejtimes.com/news/uae-health/nearly-7- in-10-young-emirati-men-overweight-obese-study 11  Medical and Nutritional Interventions Weight loss is recommended (5% to 10% reduction) Surgical intervention results in greater % of weight loss than from diet and exercise Assessment Basis for personalized approach and customized advice Measure BMI 12  Medical and Nutritional interventions:Assessment Assessment Parameters component Physical BMI; waist circumference; waist to hip ratio; body fat % Medical history Existing comorbidities to overweight Medical contributors to weight gain - active mental illness, Metabolic disorders; medications that lead to overweight; physical activity weight history Nutrition Nutrition history; dieting history; knowledge about nutrition Motivation and Personal reasons for weight control; personal goals; readiness for personal readiness; barriers to success change 13  Treatment Options Recommendations for weight loss should be population specific Children Pregnant females Older adults 14  Treatment Options Weight management goals: Behaviors and health outcomes (short & long term). Address barriers to weight loss. Reasonable and achievable goals. A reduction of 10% of body wt. is recommended. 15  Treatment Options Weight control along life span NB weight control guidelines for adults are not always appropriate for other populations Children: Not appropriate to encourage a strict diet Need lifestyle modification Pregnant female: Weight loss is contraindicated. Older adults: Need careful evaluation – danger of malnutrition. 16  Treatment Options Lifestyle Modifications: Diet, physical activity, behavior modification 20% of overweight individuals who lose wt. through lifestyle modification can maintain a wt. loss of 10% of body weight for at least 1 year. For children focus should start with: Nutrition Behavior Physical activity 17  Treatment Options Lifestyle Modifications: Diet 1. Low-calorie diets: Range from near starvation to merely subtracting 500-1000 calories from one’s baseline daily energy needs 2. Nutrient altered 3. Novelty: Any diet that yields an energy deficit will result in weight loss. 18  A. Treatment Options: Diet - Low Calorie Starvation Very Low Calorie Low Calorie Reduced cal. than Less than or equal to 200 – 800 calories usual (incl. 200 calories Risk replacement meals) Risk Fluid & electrolyte Can be Fluid & electrolyte loss (esp. nutritionally loss (esp. potassium) balanced potassium) Inadequate No permanent Inadequate nutrient intake food behaviors nutrient intake Muscle loss learned Muscle loss 19  Treatment Options: Diet- low caloric Avoid Empty calorie foods High fat and high calorie foods that contain little nutrition 20  B. Treatment Options: Diet – Altered Nutrient Diet Risks & Benefits Low carbohydrate Risk-Ketosis Less than or equal to 100 gm Often high fat carb/day Inadequate nutrient intake Low fiber May or may not be reduced calorie Moderate fat, moderate to high Generally balanced carbohydrate May or may not be reduced calorie  50% of calories-carbohydrate  25-35% as fat Low fat or very low fat High carbs. can lead to high triglycerides,  40 or BMI >35 + obesity-related condition Types: 1. Restrictive: Gastric banding, adjustable banding 2. Restrictive / Malabsorptive: Roux-en-Y, Biliopancreatic diversion (BPD) 28 Bariatric Surgery 29  Surgical Interventions Risks of Bariatric Surgery 1. Operative mortality (