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Obesity
India S. Sharp, BSN, RN
November 02, 2013
Objectives
 Provide knowledge of the pathophysiology,
epidemiology, symptoms, & nonpharmacological treatments
Obesity
 Obesity is a label for ranges of weight that are greater
than what is considered healthy for a given height.
 Obesity is having an excessive amount of body fat. It
increases risk of disease and health problems such as Type
2 Diabetes, Coronary artery disease (CAD), hypertension,
stroke, gallbladder disease, cancer, osteoarthritis, and
hyperlipidemia. Weight loss can reduce these risks by 10%.
 Obesity is a chronic relapsing disease needing
management in other disease such as diabetes and
hypertension with physical, psychological, and social
consequences.
 Abdominal obesity, rather than body fat, can be a useful
indicator of cardiovascular and cancer related outcomes.
Measuring abdominal obesity includes waist
circumference, hip circumference, and waist-to-hip ratio.
Epidemiology
 More than one-third (35.7%) of the adults in
the United States are obese in 2009-2010.
 Obesity effects all groups in society,
irrespective of age, sex, race, ethnicity,
socioeconomic status, educational level,
and geographic group.
 Adults over the age of 60 were more likely to
be obese than younger adults.
National Prevalence
Pathophysiology
Hypertophic versus Hypercellular obesity
 Hypertrophic obesity usually starts in
adulthood and responds to weight
reduction measures.
 Hypercellulary obesity typically occurs in
persons who develop obesity in childhood
or adolescence. Hypercellular obesity may
find it difficult to lose weight without surgical
intervention.
Adult Obesity by BMI
Classification of Adult Obesity by BMI
Underweight
BMI (kg/m2)
<18.5
Normal
18.5-24.9
Overweight (Pre-obese)
25.0-29.9
Obesity
30.0-34.9
Severely Obese
Morbid Obese
>40.0
40.0-49.9
Super Obese
>50.0
Super-Super Obese (SSO)
> 60.0
Etiology
 Obesity is the imbalance between energy
intake (Eating too much) and energy output
(not exercising or too little).
Predisposing Factors
Predisposing Factors
 Metabolic factors (Leptin levels)
 Smoking Cessation
 Genetic factors (Family history of
 Pregnancy and menopause
obesity)
 Level of activity (Lack of
exercise/sedentary lifestyle,
Television (TV), computer, and
hand-held game use more than 3
hours/day, and increase leisure
time)
 Endocrine factors
 Race, sex, and age factors
 Ethnic and cultural factors (Ethic
background: African American,
Hispanic)
 Socioeconomic status
 Psychological factors
 History of gestational diabetes
 Lactation history in mothers
 Dietary habits (consuming too
many calories/high fat diet, Poor
dietary choices, and/or Readily
available food sources, especially
fast foods)
Common Complaints/Signs and Symptoms
Common Complaints/Signs and Symptoms
 Difficulty performing routine daily activities, including hygiene.
 Inability or lack of interest in exercising
 Shortness of breath and/or asthma exacerbation
 Incontinence
 Obstructive Sleep Apnea (OSA)
 Infertility/polycystic ovarian syndrome
 Symptoms of cholelithiasis (heartburn, indigestion, nausea, vomiting, fatigue,
headaches, light or chalky colored stool, and dark urine)
 Hypertension
Treatment Non-Medical
 Diet changes
 Low calorie
 Increase fruits and vegetables
 Eliminate alcohol and sugar-containing beverages
 Reduce intake of sweets and sugars
 Reduce fat intake
 Reduce portion sizes
 Increase water intake
 Exercise (Increase activity as tolerated)

Encourage getting up for 10 minutes each hour

Start off with just walking as tolerated
Specialist
 Dietitian
 Psychologist consultation
Discussion