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Obesity is an excessive accumulation of fat that presents a risk to one’s health. In 2017, according to the World Health Organization, over 4 million people died as a result of being overweight or obese. Obesity is a risk factor for other diseases including heart disease, stroke, and diabetes, and is associated with a number of cancers, including breast, ovarian, prostate, and colon cancers. The good news about obesity is that most of the causes are preventable and reversible, even though the chief culprits in the rise in obesity are the changes in our diets in recent years to more foods high in fat and sugar and decreases in physical activity. We now know what to do: changing our diet by reducing fats and sugars and increasing the amounts of fruits, vegetables, and whole grains, and increasing our levels of regular physical activity can make a difference. The challenge is maintaining these behavior changes.
Handbook of Health and Behavior: Psychological Treatment Strategies for the Nursing Home Patient
Joseph M. Casciani, PhD
This is part of a series where Dr. Casciani makes you aware of and informs you about series medical conditions your patient or loved one may be facing.
A more detailed, clinical, and complete description can be found in the handbook.
Medical Condition – OBESITY
Obesity is a condition of excess body weight and may be defined as over 25% body fat in females and over 20% body fat in males. The concept that obesity is a will-power or self-discipline problem is outmoded. However, there is no clear understanding of the biochemical defects that cause it. Frequent signs and symptoms include excessive body fat composition, emotional problems, and poor exercise tolerance. Excess weight increases the heart’s work. There are several possible causes, including:
• genetic factors
• environmental factors, such as diet and eating habits, levels of activity, stress (emotional and physical), other emotional problems, drugs, and cultural orientation
• metabolic and endocrine disorders
• other factors not fully understood as yet (development issues and physiologic regulation that involves the “set point” theory to explain the difficulty obese people have in losing weight and maintaining weight loss)
• brain damage, in rare cases
What are the Medical Consequences?
Obesity can contribute to the development of diabetes, high blood pressure, heart disease and gallbladder disease, and elevated cholesterol and triglyceride levels. It complicates treatment and may even decrease survival chances of patients with stroke, kidney disease, arthritis, and other disorders. Psychosocial complications include poor self-image, limited social contacts and social interactions.
What are Contributing Factors?
Environmental factors that contribute to frequently eating high-fat, high-calorie foods, or in excessive portions, and over-consuming the necessary food intake; sedentary, inactive lifestyle; depression and poor self-image.
What Negative Attitudes can Develop?
• It’s too hard to restrict my eating/exercise.
• I have few enough pleasures as it is to deprive myself.
• I’ll feel better, happier if I eat that pie.
• It’s hopeless. I’ll never be able to lose weight.
• It’s okay to eat this. I’ll get serious about dieting/exercising tomorrow when I feel better.
• What a pathetic thing I am for eating like a pig and getting so fat.
• Dieting is just too hard. I always fail.
• If I eat something that I should not, I may as well give up for the day.
• I should always eat as little as possible.
• I cannot exercise I just have no will power.
• It won’t matter if I eat just one………
For Professionals – Themes And Strategies in Behavioral Treatment can be found in the Handbook.
