Question

You recently received a notification from a primary care physician about some alarming test results for Mr. Walker. His tests indicate that he is pre-diabetic and his BMI is 32. The physician requests a home visit to determine more information on Mr. Walker’s lifestyle. What information would you gather when you visited Mr. Walker? What would be the next steps in assisting Mr. Walker?

Answer 1

Ans) As excess body weight increases, you are more likely to have increasing insulin resistance and the development of high blood sugar – first at prediabetic levels and then in diabetes. 1.6 times as high if your BMI is 25-29.9 (Overweight).

- Obesity often has more than one cause. Environmental, psychological, genetic, and other factors all may play a part.

Questions relating to this would be asked to get information.

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Environmental factors: A person's environment plays a significant role in weight status. Environment includes lifestyle behaviors, such as what a person eats and how active he or she is. Americans tend to have high-fat diets, often putting taste and convenience ahead of nutritional content when choosing meals. People can change what they eat and how active they are as a means of changing their weight status.

Psychological factors: Psychological factors also may influence eating habits. Many people eat in response to negative emotions such as boredom, sadness, or anger.

About 30% of those who seek treatment for serious weight problems have difficulties with binge eating. During a binge eating episode, people eat large amounts of food while feeling they can't control how much they are eating. Those with the most severe binge eating problems are considered to have what is called binge eating disorder. These people may have more difficulty losing weight and keeping the weight off than people without binge eating problems. Some will need special help, such as counseling or medication, to control their binge eating before they can successfully manage their weight.

Genetic factors: Obesity tends to run in families, suggesting that it may have a genetic cause. However, family members share not only genes but also diet and lifestyle habits that may contribute to obesity. Separating these lifestyle factors from genetic ones is often difficult. Still, growing evidence points to heredity as a strong determining factor of obesity. In one study of adults who were adopted as children, researchers found that their subjects' adult weights were closer to their biological parents' weights than their adoptive parents'. The environment provided by the adoptive family apparently had less influence on the development of obesity than the person's genetic makeup. However, many people genetically predisposed to obesity do not become obese or are able to lose weight and keep it off.

Other causes of obesity: Some illnesses can lower the metabolism or trigger an increased appetite which can cause obesity. These include hypothyroidism, Cushing's syndrome, depression, and certain neurologic problems. Certain drugs, such as steroids and some antidepressants, may cause excessive weight gain through the same methods. A doctor can determine if a patient has any of these conditions, which are believed to be responsible for only about 1% of all cases of obesity.

- Management of obesity can include lifestyle changes, medications, or surgery.

The main treatment for obesity consists of weight loss via dieting and physical exercise. Diet programs can produce weight loss over the short term and long-term, although combining with exercise and counseling provide greater results.