Table of Contents
Extreme obesity is also referred to as severe obesity or morbid obesity. This is a health problem that disrupts the basic physical functions of a person and may impact on things like walking and breathing. Other than the impact of morbid obesity to the normal physical functions, it is equally associated with of other chronic health conditions. Extreme obesity is a serious health condition that is cause by an abnormal body mass index.
In the United States (U.S) and other parts of the world, obesity has been on the rise in the past couple of decades and health practitioners have diverted their attention to enlightening the public about healthy living to avoid becoming overweight and obese, which are the primary stages towards developing morbid obesity. Theoretically, any person become morbidly obese, and it results from consumption of high calorie content than the amount the body can burn and use.
The primary reason that influenced the selection of the topic of morbid obesity for research is influenced by the fact that obesity in general is a major public health concern in the U.S. There have been growing concerns about childhood and adult obesity in the recent couple of years. As the number of overweight and obese Americans continues to rise, the same happens with the number of the ones who are extremely obese. Obesity remains a major public health concern in the U.S with the prevalence rate of the disorder continuing to soar annually.
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According to CDC (2020), from 2017 to 2018, the prevalence of obesity recorded an increase from 30.5% to 42.4%, and at the same time extreme obesity’s prevalence increased from 4.7% to 9.2%. The other reason that influenced topic choice emanates from the health related conditions of obesity that comprise stroke, heart disease, and some forms of cancer, all of which contributes to premature death. Lastly, obesity is associated with significant cost of care both directly and indirectly, as evidenced by the report by CDC (2020) where the medical costs of obesity victims was $1,429 higher than that of their counterparts with normal weight. These statistics calls for the need of enhancing public awareness and coming up with intervention measures that will limit the condition.
Pathophysiology
In the 21st century, morbid obesity continues to be a major health hazard. According to Heymsfield and Wadden (2017), extreme obesity falls in the third category of obesity, which is characterized by a body mass index (BMI) of 40 or above. BMI represents the weight of an individual in kilograms divided by the height in square meters. Extreme obesity is a causative factor of other morbid conditions like heart disease, obstructive sleep apnea, osteoarthritis, type 2 diabetes, and some forms of cancer. Major causes of obesity comprise genetic susceptibility, excessive calories intake, and physical inactivity, but in some instances, gene mutations, medication, psychiatric illnesses, and endocrine disorders may be the causative factors (CDC, 2020).
Maintenance and development of the condition may involve crucial pathophysiological mechanisms like impaired brain circuit regulation as well as neuroendocrine hormone dysfunction. Although extreme obesity is a chronic condition, its treatment and management is the major treatment interventions involve physical exercise and dieting, and patients may also take anti-obesity drugs to limit fat absorption and appetite. For victims of extreme obesity, they may also be subjected to bariatric surgeries. These surgeries are recommended where individual victims are affected by the condition to a level they are almost physically inactive.
Similarities
There are lot of similarities between the textbook by Timbly et al. (2017) and the selected journal articles on the topic of extreme obesity.
One of the major similarities is that all the authors are in agreement that morbid obesity is a chronic condition that puts the lives of patients at a major risk. The high mortality risk mortality resulting from extreme obesity from all the materials used in the study are associated with the ability of the disorder to cause increased risk of other chronic conditions like heart disease, stroke, type 2 diabetes, arthritis, high blood pressure, and some forms of cancer. It is the development of these other conditions that all the authors associate extreme obesity with the capability of leading to premature death. Secondly, all the authors agree that morbid obesity is the third stage of obesity, which develops where an obese patient has a body mass index of 40 or above.
This is described as the worst obesity condition and culminates to the development of a host of other chronic illnesses discussed. Again, there is an agreement from all the authors of the impact of extreme obesity to physical functioning on the body of the victim. Specifically, the authors point to movement and breathing problems. The excessive weight is attributed to limit effective movement as patients of the condition are incapable of supporting their body weight. Breathing problems are associated with blocked air pathways by the excess fat in the body. Again, all the authors are in agreement on the causative factors of extreme obesity with high calorie content, physical inactivity, and genetic factors featuring in all the articles. When it comes to treatment; all the authors point to physical activity and dieting as the primary measures.
Differences
Irrespective of the vast similarities in the articles and the textbook about extreme obesity, there are some minor differences in their discussions. One such difference is evidenced in the treatment of the condition. Only one article by Zhang et al. (2014) and the textbook discuss bariatric surgeries to morbidly obese patients.
In their discussions, the authors attribute the procedures to be effective in reducing stomach volume as well as nutrient absorption, which they also claim to induce faster satiety. The other difference between the textbook and most of the other journal articles is evidenced in the textbook’s inclusion of weight loss drugs in addressing extreme obesity. Tmbly et al. (2017) claim that four weight loss drugs are currently approved by the U.S Food and Drug Association, which are lorcaserin, xenical, qysmia, and contrive. Therefore, the major differences between the text and the journal articles used in the current study are based on the former’s detailed focus on treatment of extreme obesity.
Clinical Scenario
In clinical setting, the issues discussed in the text and articles evaluated are evidenced while dealing with victims of morbid obesity. First, I have encountered victims of extreme obesity in my clinical practice. One specific incident was while working with a 29-year old, African American male client who had a body mass index of 42.5. Once the client arrived at the facility and reported having breathing problems, it was evident from the onset that he was obese, something that was equally known to the client and the family members.
Although I could tell the client was obese based on the physical appearance, I subjected the client to the physical examination to ascertain the level/stage of the condition and it was only at this point that I realized that the patient had extreme obesity. I also collected the patient’s history to ascertain the other symptoms he experienced, which were related to the condition. Further information collected during the patient’s history’s collection process involved the patient’s lifestyle and work. I also subjected the client to other tests to ascertain whether he was a victim of high blood pressure and diabetes, which were positive.
Previous Knowledge
Prior to the study, I had knowledge about the problem of obesity, which was confirmed during the study. One thing which I already knew and was confirmed during the comparison relates to the issue of obesity being a major public health concern in the U.S. News from the poplar media have continuously sensitized the public about the growing public issue of overweight and obesity, something that was confirmed by the study materials.
The other issue that I already knew and was confirmed during the study relates to physical inactivity and consumption of high calories content than the body requires as the leading causes of overweight and obesity. High consumption of junk drinks and foods, which possess high calories content, has been attributed as the primary cause of the surging incidents of an overweight and obese population in the U.S. I was also aware that physical activity is a crucial measure in the management of obesity. Lastly, I was aware that obesity is the primary causative factor of various chronic conditions and contributes to the high cost of healthcare, something that all the authors agree.
New Insights
While it is true that the readings reinforced my previous knowledge on obesity, they also added my knowledge about the health condition. One such important lesson came from the revelation that obesity causes breathing problems. This physical problem of obesity has never crossed my mind. The other revelation came in the form of bariatric surgeries to morbidly obese patients, which are used to reduce stomach volume together nutrient absorption and also inducing faster satiety. Lastly, I learned that there is a connection between genetic factors and obesity. Therefore, an individual’s family history about obesity is a major factor to consider in ascertaining the possibility of developing the condition.
Conclusively, the study reveals that extreme obesity is a major public health concerns that leads to inability to undertake daily routines and leads to premature deaths. Other than causing walking and breathing challenges, morbid obesity causes other chronic illnesses. Additionally, there is a direct high cost of morbid obesity related to treatment management measures among patients while compared to their counterparts without the condition. Indirect costs comprise management of other health conditions induced by morbid obesity and lost resources as the condition limits victims from working, causative factors of the condition comprise high calorie content consumption than the body requires, physical inactivity, and genetic composition. Management and treatment involve medication, physical activity, and bariatric surgeries to morbidly obese patients.
References
- Barbara Kuhn Timby, R., & Nancy E. Smith, R. (2017). Medical-Surgical Nursing- Fundamental Nursing skills and Concepts, 12th ed.
- CDC. (2020, February 27). Obesity is a common, serious, and costly disease. Centers for Disease Control and Prevention. https://www.cdc.gov/obesity/data/adult.html
- CDC. (2020, April 3). Defining adult overweight and obesity. https://www.cdc.gov/obesity/adult/defining.html
- Heymsfield, S. B., & Wadden, T. A. (2017). Mechanisms, pathophysiology, and management of obesity. New England Journal of Medicine, 376(3), 254-266. https://doi.org/10.1056/nejmra1514009
- Zhang, Y., Liu, J., Yao, J., Ji, G., Qian, L., Wang, J., Zhang, G., Tian, J., Nie, Y., Zhang, Y., Gold, M., & Liu, Y. (2014). Obesity: Pathophysiology and intervention. Nutrients, 6(11), 5153-5183. https://doi.org/10.3390/nu6115153
