NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

Student Name

Capella University

NURS-FPX 8045 Doctoral Writing and Professional Practice

Prof. Name

Date

SYNTHESIS OF THE EVIDENCE: SUBSTANTIATING AN INTERVENTION FOR OBESITY

Obesity affects 42% of adults, resulting in healthcare spending of $3.8 trillion in 2019 (State of Nevada, 2021). Despite increased recognition as a chronic disease, obesity remains underdiagnosed and undertreated (Caterson et al., 2019). In obese female patients, the impact of screening for readiness to change, introduction of a weight loss bundle with diet and exercise education, and monthly check-ins compared to no intervention on weight loss education compliance during a primary care clinic office visit at 4 weeks and 8 weeks will be explored (American Diabetic Association, 2021; Sutton, 2022; ElSayed et al., 2022; Gaesser & Angadi, 2021; Lin & Li, 2021; Ruban et al., 2019; Samuel N & Megan, 2019; Wyatt, 2018).

CRITICAL REVIEW OF THE LITERATURE

The American Diabetic Association (2021) emphasizes the need to assess patients’ readiness for behavioral changes related to weight loss. The transtheoretical model, comprising pre-contemplation, contemplation, preparation, action, and maintenance stages, offers a framework for understanding and promoting readiness for change (Sutton, 2022). ElSayed et al. (2022) highlight the link between obesity and the risk of type 2 diabetes, supporting the feasibility of long-term weight loss. Gaesser & Angadi’s (2021) meta-analysis underscores the mortality benefits associated with overweight BMI categories, providing insight into weight-neutral strategies. Lin & Li (2021) stress the importance of understanding the quality of food sources and nutrients in obesity management. Ruban et al. (2019) review various strategies, including dietary, pharmacological, and surgical approaches. Samuel N & Megan (2019) advocate for lifestyle counseling, diet, exercise, medications, and bariatric surgery in obesity management. Wyatt (2018) emphasizes the role of adherence to diet in predicting weight loss success.

SYNTHESIS OF THE LITERATURE

Obesity, a complex interplay of genetic and environmental factors, requires a comprehensive approach encompassing metabolic, social, cultural, behavioral, physiological, and genetic considerations (American Diabetic Association, 2021; Sutton, 2022; Lin & Li, 2021). Assessing readiness for change is crucial, involving an understanding of the benefits of behavior change (American Diabetic Association, 2021; Sutton, 2022). Screening for readiness to lose weight using theoretical models aids in tailoring interventions (Sutton, 2022). Various interventions, such as dietary modifications, calorie restriction, macronutrient composition, meal replacement, pharmacotherapy, exercise, and bariatric surgery, contribute to obesity management (Ruban et al., 2019; Samuel N & Megan, 2019; Wyatt, 2018).

EVALUATE THE QUALITY OF THE LITERATURE

Using the Strength of Recommendations Table (SORT) and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, the literature exhibits varying levels of evidence. High-quality evidence from studies like ElSayed et al. (2022) and Gaesser & Angadi (2021) supports the feasibility and mortality benefits of weight loss interventions. Medium-grade evidence from Lin & Li (2021) emphasizes the role of food quality in obesity. Wyatt (2018) and Samuel N & Megan (2019) provide Level 1, SORT category A evidence, emphasizing the importance of diet adherence and the multifaceted approach to obesity management.

CONCLUSION

Obesity is a significant health and economic crisis, affecting 42% of adults. Readiness for change and tailored interventions, including dietary modifications, physical activity, and bariatric surgery, are crucial in addressing this complex issue. The literature, characterized by varying levels of evidence, underscores the need for a comprehensive approach in managing obesity. Future studies could further explore gender-specific interventions and long-term outcomes.

REFERENCES

American Diabetic Association. (2021). Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement_1), S113–S124. https://doi.org/10.2337/dc22-s008

BMJ Best Practice. (2023, January 12). What is grade? Retrieved January 14, 2023, from https://bestpractice.bmj.com/info/us/toolkit/learn-ebm/what-is-grade/

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M., Prahalad, P., Pratley, R. E., Seley, J., Stanton, R. C., & Gabbay, R. A. (2022). Obesity and weight management for the prevention and treatment of type 2 diabetes. Diabetes Care, 46(Supplement_1), S128–S139. https://doi.org/10.2337/dc23-s008

Freeman, E. E., McMahon, D. E., Fitzgerald, M., Robinson, S., Frazer-Green, L., Hariharan, V., McMillen, A., Malik, S., Cornelius, L., Pak, H. S., Cronin, T. A., Bordeaux, J. S., & Cooper, K. D. (2020). Modernizing clinical practice guidelines for the American Academy of Dermatology. Journal of the American Academy of Dermatology, 82(6), 1487–1489. https://doi.org/10.1016/j.jaad.2019.12.075

Gaesser, G. A., & Angadi, S. S. (2021). Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience, 24(10), 102995. https://doi.org/10.1016/j.isci.2021.102995

Lin, X., & Li, H. (2021). Obesity: Epidemiology, pathophysiology, and therapeutics. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.706978

Ruban, A., Stoenchev, K., Ashrafian, H., & Teare, J. (2019). Current treatments for obesity. Clinical Medicine, 19(3), 205–212. https://doi.org/10.7861/clinmedicine.19-3-205

Samuel N, G., & Megan, W. (2019). Approach to obesity management in the primary care setting. Journal of Obesity and Weight-loss Medication, 5(1). https://doi.org/10.23937/2572-4010.1510024

Sutton, J. (2022, October 13). How to assess and

improve readiness for change. PositivePsychology.com. https://positivepsychology.com/readiness-for-change/

Wyatt, H. R. (2018). Update on treatment strategies for obesity. The Journal of Clinical Endocrinology & Metabolism, 98(4), 1299–1306. https://doi.org/10.1210/jc.2012-3115

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity