Week_05_Overweight_and_Eating_Disorders_S3_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  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  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  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  Surgical Interventions Risks of Bariatric Surgery 1. Operative mortality (