Treatment Recommendations for Adult Obesity

Cynthia McGalliard, BSN, RN, AU MSN Student/Project Leader

Bonnie Sanderson, PhD, RN, Faculty Advisor
INTRODUCTION

SMALL TEST OF CHANGE

LITERATURE SEARCH

BACKGROUND
Obesity is a prevalent condition that
affects a considerable number of
adults in the United States. This
preventable disease is detrimental
to the health of our nation and has
become a major health concern.
BODY MASS INDEX (BMI)
Normal
19-24
Overweight
25-29
Obesity
30
TREATMENT OPTIONS
Lifestyle Modifications
Diet
Physical Activity
PU
Pharmacological Treatment
Lipase Inhibitors
Anorexiants/Appetite
Suppressants
Adrenergic Agonists
Surgical Intervention
Restrictive
Mal-Absorption
Combination of both

Target Population: Obese adults at least 19 years old

Measures: BMI, the Simple Nutritional Assessment Questionnaire (SNAQ)
and the Rapid Assessment of Physical Activity (RAPA)
Intervention:
Based on assessment, the primary care provider will
determine appropriate treatment recommendations (lifestyle modifications,
pharmacological treatment, and/or surgical intervention)
Evaluation: Post-assessment information obtained via phone interview 4-6
weeks after pre-assessment.

Database searches included CINHAL,

Medline, PubMed, and the Cochrane
Database of Systematic Review. Boolean
search through Auburn Universitys
library was a useful source. The Centers
for Disease Control and Prevention
(CDC) website was helpful with the
collection of statistical data throughout
the United States, including analysis
within each individual state regarding
obesity.

PICO Question

RESULTS
Demographics of Participants
n= 8
Age: Mean = 48.5 (+/- 15.4)
Range = 19-67 years
Gender: 50% M/50% F
50

7
20

18

16

Pre/Post SNAQ Comparison

p= NS
Mean (SD)
14.4
(0.9)

14.1
(1.0)

Pre/Post RAPA Comparison

6

RECOMMENDATIONS

p= NS

Mean (SD)

14
4

Pre/Post BMI Comparison

p= NS

12

3.5
(0.8)

3.4
(0.8)

10

45

Mean (SD)
40

8
2

1
4

35
30

35.4 (5.2)

35.5 (5.8)

Pre

Pre

Post

87.5%
Pharmacological
Treatment

12.5%
None

Post

50.0%
Surgical
Intervention

In obese patients over 18 years old, 25

Pre
Post
when is it appropriate to implement
pharmacological
and/or
surgical
interventions
in
comparison
to
CONCLUSIONS
limiting
treatment
to
lifestyle
Findings suggest:
modifications alone in order to
There were no significant changes with diet, physical activity, or BMI in
achieve a healthier weight?
the 4-6 week period.
PURPOSE
According to current practice recommendations, 7 out of 8 participants
should
be
recommended
for
pharmacological
treatment.
The purpose of this project is to

According to current practice recommendations, 4 out of 8, or , of the

determine
appropriate
treatment
participants should be recommended for surgical intervention.
recommendations for obese adults to
achieve and maintain a healthier Only 1 participant should limit treatment to lifestyle modifications alone,
according to practice recommendations.
weight.

Grade A:
Include diet, activity, and behavior
modifications in weight management
program.
Consider pharmacological treatment if
BMI >30 or >28 with comorbidities.
Recommend bariatric surgery if BMI
>40 or >35 with comorbidities.
Grade B:
Increase physical activity and reduce
sedentary lifestyles.

REFERENCES
Mechanick, J., Youdim, A., Jones, D., Garvey, W., Hurley, D.,
McMahon, M., & ... Brethauer, S. (2013). Clinical practice
guidelines for the perioperative nutritional, metabolic, and
nonsurgical support of the bariatric surgery patient- 2013
update: Cosponsored by American Association of Clinical
Endocrinologists, The Obesity Society, and American Society
for Metabolic & Bariatric Surgery*. Obesity (19307381),
21S1-s27. doi:10.1002/oby.20461
U.S. Department of Health & Human Services. (2010).
Management of obesity. A national clinical guideline.
Retrieved on June 20, 2014 from http://www.guideline.
gov/content.aspx?id=15597

A special thanks to Auburn University

School of Nursing and Physical Express.