Obesity Resources

Obesity rates have skyrocketed globally over the last few decades. Obesity presents a public health emergency because of its numerous associated comorbidities. Waist-to-height ratio is a useful add-on to body mass index (BMI) to quantify health risks and monitor progress. The causes of obesity are complex and they necessitate a degree of empathy from healthcare professionals caring for those with the condition. Researchers believe that the obesity epidemic will not begin to improve without significant governmental policy changes. Many weight loss diets exist, but no diet stands out as more favourable at the one-year follow-up mark, as maintenance of the weight lost is uncommon. This article discusses the physiology of weight changes, emphasising the crucial role of energy balance. Energy density is a useful concept for patients to understand to help identify foods which will fill them up and help facilitate a reduced energy intake. Protein and fibre are also highlighted as focus nutrients. Exercise is important for various reasons, but on its own will not usually lead to weight loss. Sleep is an often neglected yet important factor to consider in obesity management.

Awareness of the detrimental effects of smoking, environmental factors and pollution on lung health are well established. There is also awareness of the impact of obesity on the cardiovascular system with, for example, the development of diabetes, raised cholesterol levels and hypertension, but less attention is given to obesity and the association with respiratory symptoms, particularly breathlessness (both exertional and at rest) and cough, with the potential to cause either under or over diagnoses of respiratory conditions. The  relationship between obesity and respiratory diseases is complex, as it is not simply related to the physical and mechanical impact of obesity, but also associated with inflammatory cellular function and mediator activity. This article explores the evidence for the impact of
obesity on lung health.

Inflammation occurs when the body tries to protect itself from infection by foreign organisms, such as bacteria and viruses. It involves several processes in the body, including action by white blood cells (cytokines). The whole process is known as an immune response. A short sharp immune reaction is called an acute inflammatory response, such as a bee sting, while other immune responses can go on for some time and are known as chronic inflammation. Chronic inflammation is caused by a number of factors, such as carrying extra weight, pollution in the environment, and also poor diet and lifestyle. Long-term chronic inflammation can lead to diseases such as heart disease, cancers, Alzheimer’s disease, arthritis and even depression. Inflammation is also linked to metabolic changes and metabolic disorders, such as diabetes. This article looks at how diet and lifestyle can help to alleviate inflammation, with emphasis on chronic inflammation.

The State of the Nation report published in 2015 makes a case for prioritising the prevention of type 2 diabetes (T2D) (Diabetes UK, 2015). This report identified T2D as a major challenge fo the NHS which uses a significant proportion of NHS resources - almost 10% of total NHS spending, in fact - yet the Word Health Organisation (WHO) estimated that  over three quarters of T2D is preventable (WHO, 2005). Thus, the prevention of diabetes needs to be a priority for the NHS (Diabetes UK, 2015), and it makes sense that general practice nurses a priority for the NHS (Diabetes UK, 2015), and it makes sense that general practice nurses (GPNs) should be at the forefront of this strategy. 

In each issue of the Journal of General Practice Nursing we investigate a topic currently affecting our readers. Here, Binkie Mais asks...

How can we stop Britain from being ‘the fat man of Europe’?

Despite numerous public health campaigns encouraging us to drink and smoke less, eat more healthily and take-up some form of exercise, the UK population is still facing an obesity epidemic. Indeed, one in four British adults are said to be obese, according to the UN Food and Agriculture Organisation and, if current trends are not reversed, more than half the population could be obese by 2050.

Whichever newspaper you read or news channel you tune into, there’s a fair chance that it will at some time have featured a forthright word or two from the respected National Obesity Forum [NOF] on the government’s inaction over obesity. Forum members, like you, witness the ravages of excess weight daily in their surgeries and clinics with a growing sense of frustration. But, how does the NOF get its position covered?

The Journal of General Practice Nursing asked Tam Fry, for 12 years the Forum’s spokesman, to explain.

Statistics suggest that one in four adults are obese, and up to 33% of school-aged children are overweight or obese (National Obesity Forum, 2015). Thus, on a daily basis, it is likely that general practice nurses (GPNs) will engage in consultations with patients who are overweight or obese, quite often while presenting for advice for another condition. This article explores how to broach this sensitive issue and the GPN’s role to reduce weight stigma in line with the new Nursing and Midwifery Council Code (NMC, 2015). Practical advice for GPNs to support patients in managing their weight, and identifying appropriate onward referrals, including for bariatric surgery and eating disorders, will also be discussed.