How to care for an obese relative

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Do you know how to be sure to treat obese patients?

Do you take care of patients with pain?

Does Obesity Matter If You Have Medical Treatment?

Do you have treatment strategies for obese patients?

EDs report that the numbers are increasing dramatically

(Editor’s note: This is the first in a two-part series focused on improving care for obese patients in emergency departments. This month’s story is about special considerations and management considerations. Next month, we will discuss the complications of surgical treatment for morbid obesity. It may be evident in your ED.)

Would you be able to manage the airway, perform an intravenous (IV) line, or determine exact drug doses for a 300-pound patient in your ED?

"Abbiamo sicuramente notato un aumento del numero di pazienti obesi nella nostra HED", riferisceStephanie J. Baker, RN, BSN, CEN, MBA / HCM, Director of Emergency Services at Paradise Valley Hospital in National City, CA. According to a recent study, the incidence of severely obese adults quadrupled between 1986 and 2000. 1

To improve care for obese patients in HED, do the following:

Be prepared to use alternatives to obtain adequate airways.

Because intubation can be more difficult in obese patients, a bag valve mask should always be available, advises Baker. “You may need to have a bursa for one person and hold the patient in a chin or jaw elevation position to better open the airways,” she says.

Difficult airway devices or emergency surgery may be needed in some cases, Baker adds. “It is imperative that these sterile materials and trays are readily available in the emergency room,” he says.

Make sure that intravenous access is achieved.

Because many obese patients have no visible venous structure, ask patients if they know where their blood is usually collected, advises Baker. “Obese patients often know what works for them, and that avoids unnecessary sticks,” she says.

It may be easier to start an IV in areas above the bony protrusions with fewer bands, such as the thumb, wrist, top of the foot, or the saphenous vein in the medial ankle, Baker advises. He adds that applying a warm towel to that area for a few minutes can cause the blood vessels to dilate enough to see the vein.

The outer central jugular line may need to be considered, he saysJane Lashock, RN, BSN, CEN, emergency room nurse and bariatric nurse coordinator of the Greater Hazleton (PA) Health Alliance.

“The collarbone area is generally not an area with a lot of fat distribution, so that could be an advantage,” he says. “However, accessing the outside of the neck can be a challenge for a thick neck.”

Keep patients comfortable.

Here are three simple ways to improve the comfort of obese patients:

Provide adequate bedding."Usiamo camici obesi che sono molto più grandi e possono coprire modestamente un paziente che pesa fino a 500 libbre", afferma Baker.

Move patients to normal hospital beds."Ciò renderà il tuo paziente molto più a suo agio, preverrà danni alla pelle e consentirà al paziente di avere un letto autocontrollato, riducendo così il carico di lavoro per il personale del pronto soccorso", afferma Baker.

Offer patients heavy walkers instead of crutches.Obese patients have difficulty balancing their hands, which can cause nerve damage due to the weight distributed in the armpits, advises Lashock.

Address potential drug problems.

Unexpected distribution or absorption of intramuscular drugs stored in fat can occur, Lashock says.

Additionally, the average intramuscular needle is 1 1/2 inches long, which generally only penetrates the subcutaneous tissue and not the morbidly obese muscle, he says. Considering alternative routes of drug administration, such as oral or intravenous, Lashock recommends.

Additionally, larger amounts of weight-based medications such as atropine may need to be given, Lashock says. To address this problem, it is suggested that a dosing schedule be formulated for obese patients, as is the case with pediatric dosages.

Take more X-rays near your bed.

To avoid transportation of obese patients, portable chest X-rays are done at the patient’s bedside, Baker says. “The advantages are faster results and less patient movement, and the disadvantages are only one view instead of two,” she says.

Obese patients also receive bed x-rays of the extremities, arms, abdomen, hip, and pelvis, Baker says. “Again, you might sacrifice a little on quality or number of impressions. But that’s usually enough for you to determine your disposition or whether other tests are indicated,” she says.

Avoid worsening the patient’s respiratory condition.

If patients lie on the board, the weight on the diaphragm and chest can be detrimental to their respiratory condition, Lashock says. “So we have to work quickly at clearing their cervical spine, and tilt the to bed up higher while they’re still on the board, to help facilitate tidal volume,” she advises.

Assess the need for special equipment.

Self-assessment of erectile dysfunction equipment such as stretchers, boards and cervical collars to ensure the safety of obese patients, recommends Lashock.

"Se le sedie hanno un limite di peso di 250 libbre e una persona di 600 libbre rompe una sedia e si ferisce, l’ospedale è responsabile", avverte.

ED, based in Paradise Valley, recently purchased six wider carts with sturdier side rails, thicker mattresses, and an extra wheel for stability for about $ 3,000 each, Baker says.

When evaluating equipment, consider the width and weight it will be able to hold, advises Lashock. For example, the average plate width is approximately 18 inches and the load capacity is 350 lbs. “I’ve seen a board that supposedly holds 1,000 pounds, but the width wasn’t even better,” she notes.

1. Sturm R. Increase in clinically severe obesity in the United States, 1986-2000.Arci Intern Med 2003; 163: 2.146-2148.

For more information on how to improve the care of obese patients, please contact:

More than a third (39.8%) of American adults are obese, according to a 2017 report released by the National Center for Health Statistics. A person is considered clinically obese if their body mass index (BMI) is 30 or higher. Overweight and obesity have become pressing health problems around the world.

As the number of bariatric and elderly patients increases, the need for qualified nursing and rehabilitation facilities that can meet their unique care needs increases. In the past, bariatric patients have faced challenges in trying to find accommodation for the elderly.

There are Qualified Nursing Centers (SNFs) and Assisted Living Centers (ALFs) that can accommodate obese people and provide excellent care, but finding them may require a little more effort and research.

How to find a long-term care facility for an obese senior

  1. Specialized equipment. Ask if the facility has or can obtain bariatric equipment. The Office for Occupational Safety and Health (OSHA) limits the number of health care workers they can lift, so if a loved one needs help getting up and out of bed, using the restroom or bathing, they will specialized and durable equipment to assist with medical transfer. This can include larger beds (a standard hospital bed can only hold up to 350 pounds), chairs, wheelchairs, and shower and toilet aids and equipment, depending on their needs. A heavier person may also require an electric patient lift instead of manual equipment such as a Hoyer manual lift.
    As these items are extremely expensive, the number of beds available for the heavier occupants in a given location is generally very limited. Waiting lists are often long because long-term care facilities are not obliged to accommodate patients like hospitals.
  2. Adequate training. Moving patients can be difficult and unsafe for people of average weight, so special care should be taken when professional healthcare workers care for heavier occupants. This is for the patient’s safety and that of the facility’s employees.
    „Największym ryzykiem jest kwestia zranienia pacjentów i opiekunów przez niewłaściwe techniki przenoszenia” – wyjaśnia Jeff Oldroyd z Holladay Healthcare, domu opieki znajdującego się w Salt Lake City w stanie Utah. “We provide our guardians with additional training on these specific transfers. This training is usually conducted by experienced nurses and physiotherapists. ”
    Don’t be afraid to ask the facilities about specialized training, experience requirements, and protocols for staff who may be caring for your loved one. Frequent relocation and repositioning can be difficult, but they are critical to maintaining proper hygiene and preventing pressure or pressure ulcers.
  3. Adequate space in the accommodation. A spacious room or suite is ideal for older patients in nursing homes, but be sure to check out common areas like dining rooms and exercise areas. Isolation can be a real problem for bariatric seniors as their mobility is generally limited. Make sure there is enough space throughout the facility to maneuver a larger wheelchair so that your loved one can interact with staff, guests, and other residents outside her room. Giving seniors the opportunity to engage and participate in social and recreational activities will improve their quality of life and may even lead to weight management or even weight loss.
  4. Relevant actions. While citizen involvement is important, bariatric patients also have specific health and activity needs. In many cases, traditional forms of exercise are neither feasible nor safe for them. Be sure to ask the facility about modified activities for a loved one, especially if they have recently had surgery. This is important in a rehabilitation setting where the patient works to heal and regain or improve her functional abilities. For example, a facility with a swimming pool and water therapy program would be a better option for an overweight senior than a facility that only offers typical exercise programs with moderate load and impact. However, an experienced physical therapist should be able to tailor a PT regimen to help a loved one achieve their personal health goals.
  5. Compassionate staff. Overweight patients are probably used to commenting on weight and exercise. But, to beyond the equipment and therapy, it’s important to know that the staff will see a bariatric patient as more than just a numto ber on the scale. It can be difficult for anyone to find a place on the property and you want to be sure that any special needs of your loved one are met with respect and dignity. Se la tua struttura dispone di un letto bariatrico aperto, ha senso intraprendere il viaggio osservando le interazioni tra il personale e i pazienti e contattando alcuni membri del personale per conoscere le loro personalità.
  6. Ask your loved one’s doctor. Doctors often have contacts in many specialized nursing, care and rehabilitation facilities in their area. In many cases, they can be your best source of information when it comes to finding a reputable property. Communication to between the facility and your loved one’s physician will to be key for coordinating ongoing care, so receiving a referral from their doctor will to be an added bonus.
    “We have additional communications with physicians for patients with special needs such as obesity,” says Mark Hymas, executive director of Copper Ridge Health Care, SNF in West Jordan, Utah. “There are specific protocols for each diagnosis and these symptoms are monitored and shared with doctors in real time. Doctors are then able to make decisions to monitor and adapt treatment. ‘

Seniors of all sizes can face significant obstacles and frustrations with their health care. It can be difficult to find a facility with the right equipment and training, adequate space, appropriate activity and therapy programs, and compassionate staff. However, these tips will help you in finding a suitable health resort for your loved one.

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  • 1 Rutgers University School of Nursing-Camden, Camden, NJ; email: janice. beitz @camden. conductors. education.
  • PMID: 25581606
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  • 1 Rutgers University School of Nursing-Camden, Camden, NJ; email: janice. beitz @camden. conductors. education.
  • PMID: 25581606

Abstract

Morbid obesity is a chronic disease that affects millions of Americans. The ailment is likely to get worse as a third of the US population is customary to obese. Many factors are associated with morbid obesity, including psychological (e. g. depression), physiological (e. g. hypothyroidism), sleep disturbances (e. g. somnolence), drug therapy (antidepressants, antidiabetic agents, steroids) and genetics. The growing number of morbidly obese patients requires intensive care, which poses a serious challenge to professional staff in all disciplines. This manuscript presents a case study describing the experiences of a morbidly obese woman in the later years of her life from the perspective of a relative of a healthcare professional. The patient has many important risk factors for severe obesity; her story of her reveals many of the problems she faced as she moved in and out of the ICU and ICU system. Her severe health problems affected many body systems and included hypothyroidism, congestive heart failure, hyperlipidemia, and subclinical Cushing’s syndrome, possibly related to previous medical therapy (cortisone) for childhood rheumatic fever. The case report addresses many of the problems encountered by the patient with the veneer system; Skin lesions and infections that can be life-threatening for a morbidly obese patient must be prevented or treated effectively. Healthcare professionals can learn a lot and improve the care they provide by listening to morbidly obese patients.

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  • 1 Department of Developmental Psychology, Personality and Social Psychology, University of Ghent, H. Dunantlaan 2, 9000 Ghent, Belgium. Sandra. Verto beken @ UGent. to be
  • PMID: 23524063
  • DOI: 10.1016 / j. brother 2013.02.006

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  • 1 Department of Developmental Psychology, Personality and Social Psychology, University of Ghent, H. Dunantlaan 2, 9000 Ghent, Belgium. Sandra. Verto beken @ UGent. to be
  • PMID: 23524063
  • DOI: 10.1016 / j. brother 2013.02.006

Abstract

For oto bese children to behavioral treatment results in only small changes in relative weight and frequent relapse. The current study investigated the effects of an Executive Functioning (EF) training with game-elements on weight loss maintenance in oto bese children, over and above the care as usual in an inpatient treatment program. Forty-four children (8-14 years), who were in the last months of a 10-month inpatient treatment program at a pediatric medical center, were randomly assigned to the control group with a 6-week EF training or to the check as usual. . The EF training consisted of 25 braking and working memory training sessions. Treatment outcomes included children’s performance of cognitive memory and working memory inhibitory tasks and child care staff assessment for EF symptoms and sustained weight loss after leaving the nursing home. clinic. Children in the EF training state showed significantly greater improvements than children in the care group as usual only in the working memory task, as well as in working memory and metacognition reports by caregivers. They were also more able to sustain weight loss for up to 8 weeks after training. This study shows promising evidence for the efficacy of an EF-training as weight stabilization intervention in oto bese children.

Memberships

  • 1 Department of Orthopedic Surgery, Mercy Philadelphia Hospital, 501 South 54th Street, Philadelphia, PA, 19143, USA. mmeller @ verizon. InterInternet.
  • 2 Department of Orthopedic Surgery, Drexel University College of Medicine, Philadelphia, PA, USA.
  • 3 Department of Orthopedic Surgery, University of Illinois College of Medicine, Chicago, IL, USA.
  • 4 Exponent Inc, Philadelphia, Pennsylvania, USA.
  • 5 Exponent Inc, Menlo Park, California, USA.
  • PMID: 27562787
  • PMCID: PMC5052212
  • DOI: 10.1007 / s11999-016-5039-1

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  • 1 Department of Orthopedic Surgery, Mercy Philadelphia Hospital, 501 South 54th Street, Philadelphia, PA, 19143, USA. mmeller @ verizon. InterInternet.
  • 2 Department of Orthopedic Surgery, Drexel University College of Medicine, Philadelphia, PA, USA.
  • 3 Department of Orthopedic Surgery, University of Illinois College of Medicine, Chicago, IL, USA.
  • 4 Exponent Inc, Philadelphia, Pennsylvania, USA.
  • 5 Exponent Inc, Menlo Park, California, USA.
  • PMID: 27562787
  • PMCID: PMC5052212
  • DOI: 10.1007 / s11999-016-5039-1

Abstract

Background: Patients with morbid oto besity, defined as a BMI greater than 40 kg/m 2 , and super oto besity, defined as a BMI greater than 50 kg/m 2 , increasingly present for total hip replacement. There is disagreement in the literature as to whether these individuals have a higher surgical risk and cost associated with an episode of care and the magnitude of these risks and costs. There also is no established threshold for oto besity as defined by BMI in identifying increased complications, risks, and costs of care. Until recently, analysis of higher BMI data was limited to small cohorts from hospital databases, based on BMI or height and weight only, often as part of multivariate analysis. On Octoto ber 1, 2010 the Centers for Medicare & Medicaid Services added a fifth digit to the BMI data, V85.xx, in the Medicare data bank, which allowed data mining of cases of patients with higher BMI. A nostra conoscenza, il nostro studio è il primo grande studio di data mining retrospettivo di Medicare che ci consente di esaminare livelli di BMI superiori a 40 e 50 kg / m 2 per determinare i rischi, le complicazioni e i costi per questi pazienti.

Questions/purposes: We sought to quantify (1) the surgical risk, and (2) the costs associated with complications after THA in patients who were morbidly oto besity (BMI ≥ 40 kg/m 2 ) or super oto bese (BMI ≥ 50 kg/m 2 ).

Methods: This is a retrospective study of patients, using Medicare hospital claims data, who underwent THA. The ICD-9 Clinical Modification (CM) diagnosis code V85.4x was used to identify patients with morbid oto besity and with super oto besity from Octoto ber 1, 2010 through Decemto ber 31, 2014. Patients without any BMI-related diagnosis codes were used as the control group. Twelve complications within 90 days of THA surgery were analyzed using multivariate Cox models, taking into account the patient’s demographic, comorbid and institutional factors. In addition, hospital charges and payments from the initial operation to the next 90 days were compared.

Results: Patients with morbid oto besity had increased postoperative complications including prosthetic joint infection (hazard ratio [HR], 3.71; 95% CI, 3.2-4.31; p Conclusions: Patients who are super oto bese are at increased risk for serious complications compared with patients with morbid oto besity, whose risks are elevated relative to patients whose BMI is less than 40 kg/m 2 . Costs of care for patients who were super oto bese, likewise, were increased. We present BMI outcomes to allow an objective basis for patient counseling, risk stratification, maintaining access to orthopaedic surgical care, and maintaining hospital operating margins.

Level of evidence: Level III, therapeutic study.

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It shouldn’t, but how

The rate of oto besity in the United States has reached epidemic proportions. In particular, the incidence of oto bese patients with end-stage OA outpaces that of the general population. When faced with the need for THA or TKA, the class III oto bese patient (morbidly oto bese BMI >40) presents several challenges. Studies published in the last decade show a clear association of increased relative risk of surgery in the morbidly oto bese patient. These studies have demonstrated longer operative times, higher cost, longer length of stay, higher rates of complications, higher risk of implant failure and development of PJI in oto bese patients. In addition, morbid oto besity often clusters with other comorbid conditions, which places patients at even greater risk. Yet, some isolated studies show overall functional to benefits, improved pain and quality of life in the morbidly oto bese patient who undergoes THA or TKA.

The issue is should morbidly oto bese patients to be required to lose weight (BMI

Clearly, patients should to be optimized to before elective TJA. The problem is how optimization is defined. Oto besity should to be among all comorbidities that are factored into the decision to offer surgery. If there are risk factors that are modifiable that can reduce the patient’s risk in a reasonable time interval, then this should to be pursued. However, I don’t think the healthcare system imposes a strict BMI eligibility criterion on all patients.

The strict screening criteria of BMI do not explain the true complexity of the preoperative risk assessment. TJA risk calculators reveal that BMI is a poor predictor of complications and that complications do not abruptly decrease at a certain BMI threshold. Complications are rare and unpredictable. Enforcing strict BMI eligibility criteria can thus result in denial of complication-free surgery to large numto bers of patients to save one patient from a complication. This would to be okay if BMI were readily modifiable for a majority of patients, but unfortunately this is not the case. Thus, well-intended, hard BMI eligibility criteria can effectively to become insurmountable barriers to surgery for many patients who would not have had a complication.

Accepting elevated risk should to be the subject of shared decision-making to between the patient and surgeon. Unfortunately, there is currently little, if any, incentive for surgeons to admit patients at slightly higher risk, especially in the age of linked payments. I do not to believe this is good for society. TJA remains profitable, even in patients with high BMI.

Of course, not all patients with high BMI are candidates for TJA. Likewise, not all orthopedic practices can adequately treat patients with high BMI. Patients should to be optimized to the extent possible for all comorbidities, including oto besity, prior to offering elective TJA, but an oto bese patient who is otherwise a suitable candidate for surgery, after a reasonable attempt at weight reduction, should have an opportunity somewhere in the health care system to undergo TJA.

  • Bibliography:
  • ACS-NSQIP risk calculator. Available at: https: // risk calculator. faces. org / Risk Calculator / Patient Information. jsp. Accessed November 26, 2018.
  • American Joint Replacement Registry Risk Calculator. Available at: http: // riskcalc. aao. organization / index. html. Accessed November 26, 2018.
  • Giori NJ et al.J Bone Joint Surg Am.2018; date of birth: 10.2106 / JBJS.17.00120.
  • Huffaker SJ, et al. Paper 136. Presented at: The Annual Meeting of the American Academy of Orthopedic Surgeons; 14-18 March 2017; San Diego.
  • We reiterate KE, et al.J. Arthroplasty. 2018; doi: 10.1016 / j. art.2018.02.031.
  • We reiterate KE, et al.J. Arthroplasty. 2018; doi: 10.1016 / j. art.2018.08.023.
  • Stanford Research and Education Center Surgical Policy Improvement TJA Risk Calculator. Available at: https: // s-spire-clintools. shiny applications. I / TJA Risk Calculator. Accessed November 26, 2018.
  • Unick JL, et al.I’m J. Med. 2013; doi: 10.1016 / j. amjmed.2012.10.010.

Nicholas J. Giori, MD, PhD,works at the VA Palo Alto Health Care System in Palo Alto, California and at Stanford University in Stanford, California.
Disclosure:Giori does not provide material financial information.

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Gary J. Viscio, Esq.

To obtain a PDF version of this article, click here.How to care for an oto bese relative

When I decided to have gastric bypass surgery over three years ago, the decision was entirely mine. Sure, I saw Al Roker and Carna Wilson on TV, but the final decision was in my hands.

Prior to the surgery, I really did to believe that it would to be taking the easy way out. After the surgery, I know this is further from the truth. I also know that oto besity, namely my oto besity, was something that I rarely liked to talk about, let alone listen to the advice from others.

Think about it. Those with oto besity probably know more about diets and exercise that those of you who are “in shape.” We’ve to been on all the diets, purchased the exercise machines, gym memto berships and diet pills. We’ve tried points, scales, fruit and hypnosis. We also know that losing weight is the most important and possibly the hardest thing we can try in our life.

Losing weight and leaving the oto besity to behind has to been proven without doubt to improve or eliminate co-morbidities that exist as a result of oto besity. Diato betes, hypertension, high cholesterol, even depression can to be significantly effected by weight-loss.

The question is; however, how to approach a close friend or loved one to discuss their health and their oto besity. Answer – very carefully.

First of all, always remember everything I said before. Now you are trying to tell us, your loved ones, something we already know. Our lives will improve significantly if we lose weight. Second, you’re about to discuss a very personal and private issue. And, finally, losing weight is probably the hardest thing we’ve ever tried to do in our lives and it is the source of tremendous frustration.

Evaluate your relationship with the person you will be talking to.

Five tips when speaking
a Loved One/Friend about Their Oto besity

Conversation with an unrelated one

Let’s say you’re planning on speaking with a friend. Perhaps someone with whom you have a very good relationship, but not one as close as you would with a family memto ber. Rememto ber, do your homework to before you speak with your friend. A wealth of information can to be found easily on the Internet, in your library or even at your own doctor’s office.

Before approaching your friend, imagine the situation in an inverted position. Would you appreciate a friend’s advice or would you find it intrusive or uncomfortable? Treat your friend as you would want to to be treated and approach them in that way. Let them know you are worried and don’t judge them. Assure them that you will to be as helpful as possible. Even if you are unable to attend support meetings with them, an open ear is always welcome. Trust me, we can all benefit from the greatest possible support, even if it’s a phone call.

Above all, rememto ber that only your loved one or friend can make the final decision. No diet, exercise routine, surgery or program is going to help if we don’t choose to help ourselves. And, that’s your goal… to get us to help ourselves. With your help, success is a real possibility.

About the Author:
Gary J. Viscio, Esq. is an attorney who specializes in appeals for denials of oto besity surgery, reimbursement and coverage, as well as oto besity discrimination. He underwent weight loss surgery in July 2003 and has so far lost over 160 pounds. He is a memto ber of the Oto besity Action Coalition Advisory Board, Oto besity Help Advisory Panel and the Board of Directors of the National Spinal Cord Injury Association. He has been involved in insurance litigation for almost 15 years.

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  5. How to help my girlfriend lose weight
  • Know the Facts About Oto besity
  • Understand Your Relationship With the Oto bese Person
  • Be a source of support for healthy eating and exercise
  • Reverse your weight loss decisions

**In the United States, oto besity affects 35 percent of the adult population, according to 2014 statistics reported by the Centers for Disease Control and Prevention 4.

Oto besity endangers people’s well-to being by putting them at risk for serious health conditions. ** Chances are you have a friend, family memto ber or coworker who is oto bese, and you want to help them get their health back on track. Instructing and encouraging someone to lose weight rarely works; weight is a personal matter and discussing it can cause great excitement and frustration. Set a positive example by maintaining your own healthy lifestyle and support any efforts an oto bese person takes to improve their quality of life.

Know the Facts About Oto besity

Simply put, to being oto bese means having too much body fat; technically it is defined as a body mass index of 30 or more. Body mass index or BMI is the ratio of body weight to height and is expressed by the equation: BMI = weight in kilograms / [height in meters x height in meters].

Oto besity increases the risk of developing heart disease, type 2 diato betes and some cancers.

An oto bese person most likely knows that making healthier choices, trimming portion sizes and moving more helps with weight loss.

But if they need a little guidance, know that a healthy weight loss rate is 1 to 2 pounds per week, which requires a calorie deficit of 500 to 1,000 calories per day. ‘) 7. Eating fewer calories than this amount is neither a healthy nor sustainable strategy and can lead to complications such as nutritional deficiencies and gallstones.

  • Simply put, to being oto bese means having too much body fat; technically it is defined as a body mass index of 30 or more.
  • Body mass index or BMI is the ratio of body weight to height and is expressed by the equation: BMI = weight in kilograms / [height in meters x height in meters].
  • Oto besity increases the risk of developing heart disease, type 2 diato betes and some cancers.

Understand Your Relationship With the Oto bese Person

How to get people to eat healthy?

Before you approach an oto bese person with a conversation about her size, consider your relationship. Ask yourself if this is your place to talk to that person about it. An oto bese person is likely aware that her size is not healthy and attracts attention, and you won’t help by confirming these obvious facts.

Esprimi la tua vera preoccupazione se hai una relazione intima, ma evita di to be condiscendente o giudicante. You may wonder how much you care about this person and if your concern is not based on looks but on genuine concern for his or her health.

If you feel discomfort or anger while talking, take a break.

You might to be able to revisit it hours, days or months later, but to be patient.

Ultimately, you can’t force someone to change, no matter how much you care. Telling someone they “should” or “must” do something is not helpful.

  • Before you approach an oto bese person with a conversation about her size, consider your relationship.
  • An oto bese person is likely aware that her size is not healthy and attracts attention, and you won’t help by confirming these obvious facts.

Be a source of support for healthy eating and exercise

Be a friend, spouse, sibling, colleague or parent first, not a weight loss coach. Follow the offers to support her weight loss efforts; for example, you can accompany her to doctor’s appointments or weight loss appointments.

If the oto bese person lives in your home with you, help prepare healthy meals and don’t bring foods into the home that she’s trying to avoid. Prepare meals and snacks that focus on lean proteins, vegetables, fruits, whole grains, and low-fat dairy products.

Support an oto bese person’s efforts to move more, too. Invite her for a walk, for example, not under the guise of exercise, but simply as a way to spend time together.

Recognize that an oto bese person, especially someone with extreme oto besity, may to be limited in movement. She may to be restricted in the type and duration of exercise she can do.

  • Be a friend, spouse, sibling, colleague or parent first, not a weight loss coach.
  • If the oto bese person lives in your home with you, help prepare healthy meals and don’t bring foods into the home that she’s trying to avoid.

Reverse your weight loss decisions

Reasons for the inclusion of elderly parents in retirement homes

Your heart may to be in the to best place, but recommending a specific diet, exercise plan or surgery to an oto bese person can backfire. If she tries your suggestion and fails, you may to be blamed. You also don’t always know a person’s particular health issues, limitations and capabilities, so specific recommendations should to be made by the oto bese person’s healthcare provider.

Although consuming too many calories, a sedentary lifestyle and genetic predisposition are often the causes of oto besity, sometimes a person is heavy for reasons out of her control. Certain endocrine disorders, medications or psychiatric illnesses can to be responsible.

Know that your support for healthy lifestyle to behaviors is valuable, though, as shown by a study published in Oto besity in 2014, involving 633 adults who were trying to lose weight. People whose friends and colleagues supported healthy eating and whose families supported their physical activity have been more successful in controlling their weight.