Fundamentals of Health Promotion for Nurses
Second Edition
Edited by Jane Wills
Short Answer Questions
Chapter 8: Obesity
1. Give four reasons why obesity is a public health priority.
- It can lead to health conditions such as type 2 diabetes, heart disease and some types of cancer such as breast cancer or colon cancer.
- Higher risk of complications following surgery such as heart attack, wound infection, nerve injury, and urinary tract infections.
- Joint problems.
- Obesity in pregnancy carries risks, including gestational diabetes and pre-eclampsia.
2. What does BMI mean?
The BMI is the ratio of a person's weight in kilogrammes to their height in metres squared (kg/m2). A BMI between 25 and 29 is considered overweight; a BMI between 30 and 40 is considered obese; a BMI over 40 is considered very obese (known as "morbidly obese").
3. Which population groups are more likely to be obese?
Obesity is more prevalent among older age groups, people from lower socio-economic groups and women from specific ethnic minority groups – Black Caribbean, Black African and Pakistani populations.
4. What accounts for the rise in obesity in high income countries in the last two decades?
An increase in sedentary lifestyles and a rise in car ownership, heavy marketing of energy-dense foods, and availability of fast food outlets.
5. Would you advise an overweight patient to cut down on potatoes or rice if they want to lose weight?
Current government recommendations are that everyone should eat plenty of fruit and vegetables (at least 5 and a variety each day), cut down on refined foods with sugar and salt, not starchy foods, and eat three meals a day including breakfast.
6. What are the problems associated with skin care in the obese patient?
Skin challenges related to obesity include: pressure ulcers, candidiasis, delayed wound healing, incontinence dermatitis, and irritation in the intertriginous areas, especially in the presence of co-morbidities, such as diabetes and immobility.
7. What are the challenges of raising the issue of weight with healthy but overweight patients?
This requires an understanding of their motivations for change and discussion beyond future health risks. All overweight patients need clear guidance tailored to their own particular circumstances as to how to lose weight. These patients also need follow-up to monitor their progress with weight loss.
8. What are the recommended levels for physical activity each week?
A healthy adult should aim for at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity such as cycling or fast walking every week – five x 30 minutes, though this could be broken up into shorter episodes of at least 10 minutes, and muscle-strengthening activities on two or more days a week.
9. How would you assess and manage an obese elderly person?
Body mass index is not a useful means of measuring obesity in the elderly. Waist circumference instead should be measured. In elderly individuals with excessive intra-abdominal fat (visceral obesity) and sarcopenia (where there is loss of muscle mass), there is the greatest risk of excess morbidity and mortality. Obesity is more common in older people but should not be regarded as inevitable and they should be encouraged to eat healthily, and older people should be encouraged to exercise.