Nursing Practice 1
Pathopharmacological
Foundations for Advanced
Nursing Practice
1
, Pathopharmacological Foundations for Advanced Nursing Practice
A. Investigated Disease Process
Obesity is defined as having a body mass index or BMI of greater than 30. Obesity is not
considered a disease but is a risk factor for other diseases like heart disease and type 2 diabetes.
One third of American adults are obese with another one third considered overweight (BMI
greater than 25 but less than 30). Parents who are obese often have children who are obese due
to genetics and environmental effects: parents and children usually eat the same foods and have
the same exercise habits (McCance & Huether, 2014).
Obesity is an epidemic with no simple solution. It is a complex problem that is going to
take individuals, healthcare professionals, state and local organizations, policy makers, and
community leaders working together to create and maintain a healthy lifestyle and environment.
Resources are available through state and local programs for health recommendations.
Community support for healthy eating and active living in different settings can help reverse
obesity. A lifestyle change is the way to achieve and maintain a healthy weight (“Strategies to
Prevent Obesity,” 2015).
A1. Pathophysiology
Obesity is defined as a BMI greater than 30 and is also considered a metabolic disorder.
When an individual with susceptible genes to obesity takes in more calories than they burn off
then obesity can develop (McCance & Huether, 2014).
There are interactions of many cytokines, hormones, and neurotransmitters which makes
the pathophysiology of obesity very complex. Adipocytes are the cellular basis of obesity and
secrete numerous hormones and cytokines called adipokines. Adipokines help regulate food
consumption, the storage and metabolism of lipids, insulin sensitivity, and many others.
2
, Accumulation of visceral fat causes the adipocytes to not function properly and results in
changes in the regulation and interaction of the hormones. These changes in the adipokines and
other hormones and neurotransmitters take part in the causes and complications of obesity
(McCance & Huether, 2014).
A2. Standard of Practice
Recommended standards for a primary care giver is to calculate a patient’s BMI, using
height and weight, on annual visits or more frequently if needed. This is the first step in
identifying those who would need to be counseled on weight lose if the BMI is >25 (overweight)
or >30 (obese). A waist circumference should also be used as a possible indicator for higher risk
of type II diabetes and cardiovascular disease. Waist circumference limit is 40 inches or more
for men and 35 inches or more for women. Lifestyle change is the most important start for
weight loss. Guidelines for weight loss are based on the patient assessment and include: a) diet,
b) physical activity, c) behavioral counseling, d) pharmacological treatments, and e) bariatric
surgery. Patient options and any health issues are included in these guidelines (“New Obesity
Guidelines: Authoritative ‘Roadmap’ to Treatment,” 2013).
A2a. Pharmacological Treatments
Treatments for obesity are based on developing a weight loss plan to improve the
patients’ health and well-being. After consulting some primary care physician offices, results
show that evidence-based pharmacological therapies in my state were comparable to the
recommended standard guidelines for weight loss. Developing a diet plan by reducing calorie
intake, increasing physical activity, and adding behavioral counseling are important for a
successful weight loss plan. Individuals with a BMI greater than 30 or greater than 27 with other
comorbidities that do not have success in losing weight with diet and exercise may need to add
3
Pathopharmacological
Foundations for Advanced
Nursing Practice
1
, Pathopharmacological Foundations for Advanced Nursing Practice
A. Investigated Disease Process
Obesity is defined as having a body mass index or BMI of greater than 30. Obesity is not
considered a disease but is a risk factor for other diseases like heart disease and type 2 diabetes.
One third of American adults are obese with another one third considered overweight (BMI
greater than 25 but less than 30). Parents who are obese often have children who are obese due
to genetics and environmental effects: parents and children usually eat the same foods and have
the same exercise habits (McCance & Huether, 2014).
Obesity is an epidemic with no simple solution. It is a complex problem that is going to
take individuals, healthcare professionals, state and local organizations, policy makers, and
community leaders working together to create and maintain a healthy lifestyle and environment.
Resources are available through state and local programs for health recommendations.
Community support for healthy eating and active living in different settings can help reverse
obesity. A lifestyle change is the way to achieve and maintain a healthy weight (“Strategies to
Prevent Obesity,” 2015).
A1. Pathophysiology
Obesity is defined as a BMI greater than 30 and is also considered a metabolic disorder.
When an individual with susceptible genes to obesity takes in more calories than they burn off
then obesity can develop (McCance & Huether, 2014).
There are interactions of many cytokines, hormones, and neurotransmitters which makes
the pathophysiology of obesity very complex. Adipocytes are the cellular basis of obesity and
secrete numerous hormones and cytokines called adipokines. Adipokines help regulate food
consumption, the storage and metabolism of lipids, insulin sensitivity, and many others.
2
, Accumulation of visceral fat causes the adipocytes to not function properly and results in
changes in the regulation and interaction of the hormones. These changes in the adipokines and
other hormones and neurotransmitters take part in the causes and complications of obesity
(McCance & Huether, 2014).
A2. Standard of Practice
Recommended standards for a primary care giver is to calculate a patient’s BMI, using
height and weight, on annual visits or more frequently if needed. This is the first step in
identifying those who would need to be counseled on weight lose if the BMI is >25 (overweight)
or >30 (obese). A waist circumference should also be used as a possible indicator for higher risk
of type II diabetes and cardiovascular disease. Waist circumference limit is 40 inches or more
for men and 35 inches or more for women. Lifestyle change is the most important start for
weight loss. Guidelines for weight loss are based on the patient assessment and include: a) diet,
b) physical activity, c) behavioral counseling, d) pharmacological treatments, and e) bariatric
surgery. Patient options and any health issues are included in these guidelines (“New Obesity
Guidelines: Authoritative ‘Roadmap’ to Treatment,” 2013).
A2a. Pharmacological Treatments
Treatments for obesity are based on developing a weight loss plan to improve the
patients’ health and well-being. After consulting some primary care physician offices, results
show that evidence-based pharmacological therapies in my state were comparable to the
recommended standard guidelines for weight loss. Developing a diet plan by reducing calorie
intake, increasing physical activity, and adding behavioral counseling are important for a
successful weight loss plan. Individuals with a BMI greater than 30 or greater than 27 with other
comorbidities that do not have success in losing weight with diet and exercise may need to add
3
