1. MEDICINE & NURSING 1
GROUP NINE (9) PRESENTATION
TOPIC :
OVER NUTRITION AND OBESITY
NURSING AND MIDWIFFER TRAINNING COLLEGE,
CAPECOAST
2. LESSON OBJECTIVES
At the end of the presentation learners will be able to:
• define over nutrition and obesity
• know the cause, signs and symptoms of over nutrition and
obesity
• prevention and complication of over nutrition and obesity
3. INTRODUCTION
• Nutrition comprises of the process of providing nutrients needed for health,
growth, development and survival. Good nutrition is important for physical
activities, movement, work and warmth. Physical growth and brain
development is essential for learning, hence good nutrition is important
especially for children and also important for body building, repair of worn-
out tissues and cells, protection form illnesses, fighting infections and
recovery from illnesses.
• Over nutrition: it is a form of malnutrition (imbalance nutrition) arising
excessive intake of nutrient leading to accumulation of body fats that
impairs health. Over nutrition occurs when an individual has excessive
consumption of food, for more than their dietary need.
4. Causes of over nutrition
EATING TOO MUCH OF CALORIE’S FOODS
EATING LATE AT NIGHT
CONSUMING MIRE NUTRIENT THAN WHAT THE BODY NEED
SEDENTARY BEHAVIOURS
EATING IN BETWEEN MEALS
5. obesity
• Obesity is a medical condition in
which excess body fat has
accumulated to an extent that can
have a negative effect on health. It is
defined as an overabundance of body
fat, resulting in body weight 20%-30%
over the average weight for the
person's age, height, sex and body
frame.
• The body weight is generally
classified according to the body mass
index (BMI). This is measured as;
BMI= Weight in kilogram(kg) / Square
of height in meters(m2)
• Under weight < 18.5kg/m2
• Ideal weight 18.5 – 24.9 kg/m27
• Over weight 25.0 – 29.9 kg/m2
• Obese 30.0 – 34.9 kg/m2
• Severely obese > 35.0-40.0 kg/m2
obesity is further evaluated using the
waist line, the accumulation of fat
around the waist. A person is said to be
obsessed when; in males the waist line
is 94cm and in female is 80cm
6. Forms of obesity
• Aside the general appearance of the whole body of an individual
exhibiting adipose deposit which is classified as obesity, there are other
areas of the human body which can be obese without other body parts.
• In females that is Gynecoid obesity, adipose tissue is found
predominantly in the lower part of the body (hips and thighs).
• Whereas in males the Android obesity type shows a dominant visceral
and upper thoracic distribution of adipose tissue.
• Another way to describe the above forms of obesity is that, gynecoid
obesity has adipose distribution below the waist whiles android obesity
has adipose distribution above the waist level.
7. INCEDENCE
• It is normally common among the middle age. Women are more
prone to obesity than men. It occurs in both infants and adults at all
age. It affects both children and adult. However, the prevalence
increases with age. However, the old are not often obese because
most of their fat as already been use up. In America, about 15% of the
population is said to be suffering from obesity. In addition, it is
believed to be a disease of the affluent. Now, Obesity showing rapid
increase in prevalence rate at urban cities of most countries. In
Ghana, nearly 43% of the adult population is either overweight or
obese. In Greater Accra region has the highest prevalence of obese. In
2015,600 million adults and 100million children were recorded
obsessed in 195 countries.
8. PROGNOSIS
• Prognosis is poor, that is fewer than 30% of patients succeed in losing about 9kg weight and only half of these
maintain the loss over a prolong period.
9. PROGNOSIS
• Prognosis is poor, that is fewer
than 30% of patients succeed in
losing about 9kg weight and only
half of these maintain the loss
over a prolong period.
10. Forms of obesity
• Aside the general appearance of the whole body of an
individual exhibiting adipose deposit which is classified as
obesity, there are other areas of the human body which can
be obese without other body parts.
• In females that is Gynecoid obesity, adipose tissue is found
predominantly in the lower part of the body (hips and
thighs).
• Whereas in males the Android obesity type shows a
dominant visceral and upper thoracic distribution of
adipose tissue.
• Another way to describe the above forms of obesity is that,
gynecoid obesity has adipose distribution below the waist
whiles android obesity has adipose distribution above the
waist level.
11. PREDISPOSING CAUSES OF OBESITY
• Pregnancy. This is by the endocrinological changes of the mother and
the fetus, insulin resistance physiologically increases leading to obesity.
• Nutritional ignorance.
• Illnesses or conditions such as duodenal ulcer, Hypothyroidisms (since
the thyroid hormones are not active when you over eat, a small
amount of it is metabolized and for that matter the rest is stored under
the skin as adipose tissues. Excess of this can lead to weight gain
causing obesity.
• Genetic factors.
• Lifestyle (behavioural).
• Social- economic variables
12. PREDISPOSING CAUSES OF OBESITY
• Psychological factors such as emotional stress when stressed out, there
is a release of the hormone cortisol that turns your overeating into a
habit.
• Drugs such as steroid (they affect your metabolism and how your body
deposit fat this can increase your appetite leading to weight gain and
particularly lead to fat deposit in your abdomen), psychiatric drug,
chlorpromazine (Largactil). Some medicines may affect your body’s
metabolism this causes your body to burn calories at lower rate some
medicines might cause you to retain water. This makes your weight
more even if you don’t put on extra fat.
• Wrong modeling and misconception of associating obesity with wealth.
13. PATHOPHYSIOLOGY
• Obesity is a chronic disease is a chronic disease a major public health concern. Obesity is a mild state of
chronic inflammation of adipose tissue and a state of malnutrition by excess that leads to defective
immune function. Excess body fat is associated with changes in leukocytes count such as monocyte,
lymphocyte, and neutrophils count. The adipose tissue produces hormone that helps in utilizing the
food substance for energy so in a situation whereby the adipose tissue is inflamed, the fat or the food
substance accumulate beneath the skin thereby making the person to gain more weight.
• The thyroid gland produces the thyroid hormone, thyroxine which helps in metabolism of food
substances such as lipid and glucose. In the case whereby the thyroid gland is not producing the
hormone for metabolism of, the cells fall on the stored fat and glucose for energy, but the ingested fat
and carbohydrates are accumulated beneath leading to obesity.
14. CLINICAL MANIFESTATIONS
The clinical
manifestations vary
and may include:
1.Excess abdominal
fat causing increase
in waist line (Trance
obesity)
1.Increased body
weight and blood
cholesterol
1.Shortness in
breathing
1.Easy fatigability
19. DIAGNOSTIC INVESTIGATIONS
• Physical manifestations
• Lipid profile.
• BMI measurement-- this is done to determine the
weight of the individual.
• Thyroid function test - this is a blood test done to
know if the thyroid gland can metabolize food
substance, this is because the thyroid gland helps
in metabolism.
• Blood glucose monitoring – this is done to know
your blood glucose level.
• Blood pressure monitoring
20. MEDICALMANAGEMENT
Diagnosing and treatment of medical disorders is essential in treating obesity. The first
treatment of choice for obesity is dietary management. How ever if the condition is life
threatening then hospitalization would be necessary for intensive management. A weight
reducing diet under the supervision of a dietician is important. This includes encouraging intake
of more vegetables and fruits, reducing carbohydrates, refined sugars and fats, as well as
increasing intake of clean water. Regular physical activity and exercises that are tolerable helps
in ensuring weight reduction. This activity must be planned with the patient to encourage
compliance. Treat patient with dignity and respect as well as psychological counselling to
promote self-image
21. SURGICAL MANAGEMENT
1. Gastric operation (endoscopic sleeve gastroplasty)- in this procedure, a suturing device is inserted into the
throat and down to your stomach. The endoscopist then places sutures in your stomach to make it smaller.
2. Gastric balloon implantation (Garran Edward’s gastric balloon)- is a non-surgical approach to treat obesity. It can
be successful in patients who have not been able to lose weight through traditional methods such as dieting or
exercising. During the procedure, the balloon is implanted into the stomach through your mouth using an
endoscope. The balloon is filled with saline to fill space in the stomach, giving you the feeling of fullness with
less food. The implant is temporary and does not alter your anatomy.
3. Intestinal bypass operations- it is a type of surgery that helps you to lose weight by changing how your stomach
and small intestine handle the food you eat. After the surgery, your stomach will be smaller. You will feel full
with less food. The food you eat will no longer go into some parts of your stomach and small intestine that
absorb food.
23. NURSING ASSESSMENT
1. Childhood weight history, this done to see if the person started gaining weight from the childhood
2. Nutritional history, this is done to see if the person takes in excess fat.
3. Sleep patterns, sleeping too much slows down the rate of metabolism, this done to see the number of
hours the person spend in sleeping.
4. Associated past medical history like thyroid problems and diabetes
5. Surgical history, this is done to see if the patient had undergone any surgery such as thyroidectomy.
6. Medication history, this is done to see if the patient has taken in or taking any medication that
promotes weight gain.
7. Social history, this is done to see if the patient had lived or living a sedentary lifestyle.
24. Nursing Management of obesity
• OBSERVATION
1. Temperature, pulse, respiration, and blood
pressure four hourly.
2. Daily weight checks.
3. Monitor patients’ emotional reactions.
4. Monitor drug served for effectiveness and side
effects (e.g., Insomnia, dry mouth, GIT
disturbances)
25. NUTRITION/HYDRATION
• Give balanced diet, low in calories and
fat.
• Explain the prescribe diet into detail to
patient and family.
• Encourage patient and family to comply
to diet regimen to improve health status.
• Healthy eating plan and regular physical
activity.
• Changing your habits.
PERSONAL HYGIENE
1. Teach patient the importance of
good skincare to prevent break
down in moist skin folds.
2. Apply appropriate cream to keep
skin dry.
26. • TREATMENT
1. Weight management programs.
2. Weight – loss medicines.
3. Weight –loss devices.
4. Special diets.
EXERCISE/REST AND SLEEP
Encourage patients to engage
in physical activities and
regular exercises such as
walking, jogging, skipping etc.
27. Medical management
I. (Drug) Appetite suppressing drug therapy.
- Ortistat (xenical) decreases fat absorption by 30%
- Amphetamine derivative (a neurotransmitter which has the
-Sibutramine
-fenfluramine
-diethylpropion
ii. Regular Exercise
iii. A modify diet: Eating fewer calorie food daily but ensuring, balance diet, low in sugar.
iv. Behaviour modification of techniques which promotes fundamental changes in eating habit
and activities pattern (needs a clinical psychologist).
v. surgery: Gastroplasty, that is stomach stapling surgery (decrease the volume of food that the
stomach can hold and thus produce satiety with small food intake).
28. HEALTH EDUCATION
1 . Ed u cate p a t i e nt t o fo c u s o n t h e d e v e l o p me nt o f h e a l t hy e a t i n g h a b i t i n t h e i r c h i l d re n
d u r i n g i n fa n c y a n d c h i l d h o o d .
2 . Te a c h p a t i e nt o n t h e e ffe c t o f o b e s i t y o n h e a l t h .
3 . E n c o u ra ge a n d s u p p o r t p a t i e nt o n r e g u l a r e xe rc i s e a n d p hys i ca l a c t i v i t y t o i m p ro v e d h e a l t h .
4 . E x p l a i n t h e p r e s c r i b e d d i e t c a ref u l l y a n d e n c o u ra ge c o m p l i a n c e .
5 . Ed u cate p a t i e nt t o fo c u s o n t h e d e v e l o p me nt o f h e a l t hy e a t i n g h a b i t i n t h e i r c h i l d re n
d u r i n g i n fa n c y a n d c h i l d h o o d .
6 . Te a c h p a t i e nt o n t h e e ffe c t o f o b e s i t y o n h e a l t h .
7 . E n c o u ra ge a n d s u p p o r t p a t i e nt o n r e g u l a r e xe rc i s e a n d p hys i ca l a c t i v i t y t o i m p ro v e d h e a l t h .
8 . E x p l a i n t h e p r e s c r i b e d d i e t c a ref u l l y a n d e n c o u ra ge c o m p l i a n c e .
30. CAUSES:
• The main cause is the increase intake of food and other calories with lack of regular physical activity or exercise. And
some other causes may include;
1. Hereditary/genetics.
2. Social pressures
3. Hormonal effect
4. Over eating with little exercise. Especially eating food high in calories without exercising ton burn some, will be stored
in the body as fat if in excess.
5. Psychological response to stress.
6. Decrease exercise level
7. Certain medications such as insulin and antidepressant drugs.
31. COMPLICATIONS OF OBESITY
1. Sudden death from Cardiac dysrhythmias related to electrolyte
imbalance.
2. Type II Diabetes – in an obese individual, the amount of NEFA,
glycerol, hormones, cytokines, proinflammatory substances and
other substances that are involved in the development of insulin
resistance are increased. Insulin resistance with impairment of β-cell
function leads to the development of diabetes.
3. Liver disease- fatty liver may cause no damage, but sometimes the
excess fat leads to inflammation of the liver. This condition, called
steatohepatitis, does cause liver damage.
4. Respiratory disorders – obesity causes mechanical compressions of
the diaphragm, lungs and chest cavity, which can lead to restrictive
pulmonary damage. Furthermore, excess fat decreases
32. COMPLICATIONS OF OBESITY
5. Gout-is a form of arthritis with an excess of uric acid in the blood.it is characterized by painful
inflammation and swelling of the smaller joints, especially those of the big toe and thumb.
6. Osteoarthritis -is a type of arthritis (inflammation of one or two bone) that occurs when flexible tissue
at the ends of bones wears down. The wearing down of the protective tissue at the ends of bones occurs
gradually and worsen. Being obsessed increases the load placed on the joints such as the knee, which
increases stress and could possibly hasten the breakdown of cartilage.
7. In pregnancy, obesity can cause a lot of complications such as gestational diabetes, hypertensive
conditions.
8. Back ache and muscular pain
9. Gastric bypass complications; malnutrition, pancreatitis, gall stone, urinary calculi etc.
10. Hypertension, etc.
33. References
Baetge C, Earnest CP,Lockard B, Coletta AM,Galvan E, Rasmussen C,Levers K, Simbo SY, JungYP, Koozehchian M, OliverJ, Dalton
R, Sanchez B,Byrd MJ, Khanna D, JagimA, Kresta J, Greenwood M, Kreider RB. Efficacy of a randomized trial examining
commercial weight loss programs and exercise on metabolic syndrome in overweight and obese women. Appl Physio Nutr
Metab. 2017 Feb;42(2):216-227. [PubMed: 28044449]
de Heredia FP, GómezMartínez S, Marcos A. Obesity, inflammation and the immune system. Proc
Nutr Soc. 2012
May;71(2):332-8.
[PubMed: 22429824]
Jukaku SA, Williams SRP. The cause of obesity is multifactorial but GPs can do more. BMJ. 2021 Apr 13;373: n956.
[PubMed:33849923]
Bosy-Westphal A, Müller MJ. Diagnosis of obesity based on body composition associated health risks-Time for a change in
paradigm.
Obese Rev. 2021 Mar;22
Suppl 2: e13190. [PubMed: 33480098]
34. List of group members
• DIANA ADU SENYAH.
• BOATENG ANGELA SERWAA
• BOTWE ABIGAIL
• ABDULAI HIDAYATU
• ACKON NANA ABA ABOKOMA
