Reduce the Proportion of Adults with Obesity

I. Introduction

Globally, obesity is rising to epidemic levels. If current trends persist, it has been estimated that the percentage of overweight or obese adults worldwide will rise from 33 percent in 2005 to 58 percent by 20301. Due to the rise in chronic diseases and disabilities brought about by obesity, which also causes several physicals, psychological, and social issues, the phenomenon of rising obesity has placed a heavy weight on the world. Obesity is physically linked to high blood pressure, high cholesterol, type 2 diabetes, cardiovascular disease, arthritis, and a few types of cancer. A person who is fat frequently experiences prejudice and discrimination in society, which has negative economic and social repercussions. Psychologically, obesity is linked to poorer self-esteem, negative self-evaluation, and lowered self-image.

The effects above frequently reduced the obese person's health-related quality of life (HRQOL). HRQOL is a product that impacts individuals' self-reports about their life, health, and medical care. This idea is linked to a person's sense of wellbeing and perceptions of their physical, emotional, and social functioning, expressed in their responses to and assessments of their health1. Obesity's poor effects on HRQOL, particularly in women, are its most frequent and direct side effects. A few research revealed significant correlations between obesity and quality of life, showing that as weight increases, quality of life declines.

The World Health Organization Quality of Life Questionnaire abbreviated version (WHOQOL-BREF) was used in a study among Turkish women of reproductive age who were not pregnant to examine the relationships between obesity and HRQOL. The results revealed that the prevalence of overweight and obesity increased with age, lower educational attainment, and lower socioeconomic status. 14.7 percent admitted to having a chronic disease and being overweight or obese1. After correcting for age, degree of education, and co-morbid illness, the obese (BMI > 30 kg/m2) women had a statistically poorer HRQOL score in all categories except environment. According to this study, being overweight or obese may hurt a person's HRQOL and increase morbidity and death.

Obesity and prevalent mental health disorders have intricate relationships. There is a bidirectional link between obesity and common mental disorders like sadness and anxiety, according to the National Obesity Observatory 2011, an overview of the present relationship between obesity and mental health among adults and children in the United Kingdom1. It also covers the subject of health disparities and the implications of psychological distress brought on by stigma and discrimination associated with one's weight. The majority of theories, however, stress that obesity increases medical conditions and limits mobility, both of which directly affect psychological health and can result in issues including low self-esteem, eating disorders, distorted body images, anxiety, and depression. Overweight and obese people tend to have negative psychological traits, a lower self-rating of their health, and worse health-related behaviors. Being overweight negatively impacts their social life, which isolates and leaves them vulnerable.

In a study on self-perception and satisfaction with life among obese and overweightrural housewives in Kelantan, Malaysia, it was discovered that over 55% of them believed that obesity represented pleasure and, conversely, that it represented sadness1. Despite the majority of participants being mindful of their weight and intended to lose it, they nevertheless described themselves as being in good or very good health. This suggests that rural housewives' public health strategies should be adjusted to the negative health effects of obesity and overweight.

Numerous studies show a strong link between obesity and morbidity and death, but not many look at how being overweight or obese affects HRQOL, particularly in Malaysia. The influence of obesity on HRQOL, particularly among overweight and obesehomemakers, must be investigated because Malaysia has the largest percentage of obese people among Southeast Asian nations, and homemakers have higher BMIs than other employment categories1. The quality of life for communities, families, and individuals and their health will improve with a high HRQOL. As a result, it will guard against chronic illnesses and mental illnesses like sadness, anxiety, and poor self-esteem.

Programs to help people lose weight may include frequent check-ins, realistic weight loss targets, and meal and exercise logs. Setting reasonable weight reduction targets can be challenging, but visual aids highlighting the positive effects of losing weight on one's health and wellbeing can be useful in discussing these targets and inspiring patients to keep the weight off. Techniques like motivational interviewing, which concentrate on overcoming resistance to behavioral change in a positive and supportive way, may assist people in integrating these changes so that they can become a part of normal daily life and so aid in maintaining the weight reduction2. Adherence should be a top priority for weight-reduction programs since positive reinforcement in the form of noticeable early weight loss may also help. People may feel more in control of their weight reduction if their sense of "self-worth" or "self-efficacy" are encouraged. Through evaluation, guidance, inspiration, goal-setting, management, and therapy, nurse practitioners play a significant part in assisting patients with weight reduction. Nurse practitioners are in a good position to make significant improvements to the weight-management techniques used in clinical practice because of their in-depth knowledge of the research in obesity and weight management. Incorporating technology to assist affected people in sticking with weight loss programs, educating populations on healthy eating habits, and treating the morbidly obese are just a few of the policy and healthcare initiatives being made to try and lessen the prevalence rates. Obesity should be managed in the formative years of adulthood to lower the proportion of obese adults successfully.

II. PREVALENCE AND FACTORS ASSOCIATED WITH OVERWEIGHT AND OBESITY

1. PREVALENCE

As a result of the excessive buildup of body fat, overweight and obesity are linked to a higher risk of advancing non-communicable diseases like cancer, diabetes, heart disease, and other medical issues. It has been anticipated that between 2005 and 2030, the proportion of people who are overweight or obese would rise significantly higher in developing countries than in economically developed ones3. The incidence of obesity in the region is fueled by the growing westernization and urbanization of sub-Saharan Africa, which are linked to poor eating patterns and sedentary lifestyles. According to recent data, some populations in Ghana, South Africa, and Nigeria had obesity prevalence rates of 17.8, 30.6, and 33.7%3. All states in the US had obesity prevalence rates of more than 20% in 2015. In 2016, the obesity prevalence increased to more than 35% in four of those 25 states (Alabama, Louisiana, Mississippi, and West Virginia)2. In the US, obesity affects roughly 35% of adult males and 37% of adult females, respectively. Non-Hispanic white Americans and non-Hispanic Mexican Americans have the highest rates of adult obesity, respectively. People are also becoming heavier earlier in life; the birth cohorts from 1966 to 1975 and 1976 to 1985 reached an obesity prevalence of 20% by the ages of 20 to 29, but the cohort from 1956 to 1965 only did so by the ages of 30 to 39.

Additionally, from 14.6 percent in 1999-2000 to 17.4 percent in 2013-2014, the prevalence of childhood obesity among children aged 2 to 17 in the United States has grown. The early development of co-morbid conditions that have serious negative health effects and the greater possibility that obese children will go on to become obese adults make childhood obesity a growing public health concern (50 percent risk vs. 10 percent for children without obesity). Over 2.1 billion individuals, or close to one-third of the world's population, are overweight or obese4.

2. FACTORS ASSOCIATED WITH PREVALENCE

Obesity prevalence is substantially connected with gender, race and ethnicity, and socioeconomic status, whichproduces complex interactions between these parameters. Food accessibility continues to play a significant role in obesity, contributing to regional variations in prevalence and greater rates of obesity among those with lower socioeconomic status. A prolonged positive energy balance can be achieved by increasing the availability of high-calorie. These high-energy food options are believed to be more affordable and reduce physical activity connected to work and commuting.

The overall health of rural men is worse than that of urban men. Their obesity puts them at significant risk for cardiovascular disease and metabolic syndrome. Due to the high amounts of physical activity required by agricultural vocations, rural men historically had a lower risk of becoming obese and overweight. However, due to the mechanization of agriculture, males now labor in more sedentary, technologically-driven professions, which increases their risk of becoming overweight or obese5. Men are less likely than women to employ weight control techniques, attempt weight loss, or participate in weight loss programs. One issue is a lack of resources for weight loss. Rural men also frequently adhere to masculine norms that stigmatize help-seeking and health promotion as weak and feminine.

Due to a lack of accessibility to medical facilities, prevalence rates in rural areas of America are between 3.6 and 7% higher than in metrpolitan areas. The higher prevalence rates of obesity in rural locations around the world are caused by a combination of factors, including limited access and cultural considerations. The adoption of poor eating practices and sedentary lifestyles that have created and exacerbated the prevalence of obesity in such countries have also been linked to the transfer of western and urban culture to developing nations6. Men in rural towns are less likely to exercise than rural women. Men in rural...

…With the current generation of young adults among the highest consumers of digital technologies like social media, mobile phones, and wireless information-sharing platforms, technology may provide a practical way to involve young adults in weight management.

An effective substitute for conventional weight management strategies is electronic health (eHealth), described as utilizing information and communication technologies (ICTs) for health. It also has the potential to be widely distributed. The first type of eHealth is telemedicine, which was initially employed in the 1920s. The development of wireless technology and broadband internet in the 1990s sparked an explosion of eHealth and mobile health apps in the medical industry. ICT-based interventions (such as internet-enabled mobile and tablet devices and wearable monitors) enable personalized, context-specific health behavior modification programs with unlimited time for coaching, support, and feedback4. Modern ICTs are widely used, mobile, and capable, enabling temporal synchronization of delivering the interventionand delivery at a convenient time and location. Young adults might receive a short (SMS) text message in the morning, reminding them that a healthy breakfast is essential for maintaining a healthy weight, along with a link to healthy breakfast recipes using ingredients typically found at home. Adult obesity has been treated with eHealth-based interventions, which have shown the capacity to encourage healthy changes in food and PA habits.

IV. WEIGHT LOSS IMPACT AND MANAGEMENT

According to weight loss research, successful weight management has been linked to improvements in co-morbid medical issues. It has been determined that sustained weight loss, attained by a healthy diet and exercise, is the main objective for enhancing health in overweight and obese people. The likelihood of long-term weight loss success is increased by implementing long-term lifestyle modifications. Getting used to large eating portions and exercising in your routine will help you lose weight.

Young adults who practice and maintain healthy behavioral patterns enjoy long-term health benefits for themselves and financial advantages for society. A 15% relative decrease in early death was correlated with a 5% weight loss. Additionally, losing weight makes managing obesity comorbidities simpler and reduces the likelihood of developing them. An effective transgenerational strategy for obesity prevention could be found in preventing unhealthy weight gain in young adults, which offers a new target for lowering the rising prevalence of obesity4. Ma et al.10 discovered high-quality evidence linking weight-reducing diets for obese individuals, typically low in fat and low in saturated fat, to an 18% relative decrease in premature mortality during a median trial duration of two years, or six fewer deaths per 1000 participants (95 percent confidence interval two to 10). This paper adds another justification for the inclusion of weight-loss regimens with their previously well-established advantages, such as the prevention of type 2 diabetes.

In comprehensive evaluations of controlled cohort studies, bariatric surgery has been linked to significantly lower rates of death, myocardial infarction,cardiovascular events, stroke, and cancer risk. BMIs of 30 to 35 were not linked to greater mortality compared to BMIs of 18.5 to 25.5, according to a systematic review and meta-analysis of population prospective cohort studies10. The Global BMI Mortality Collaboration, in contrast, discovered that obesity (BMI 30 to 35) was linked to a higher risk of death. The researchers minimized reverse causation by looking at data from non-smokers and removing the first five years of follow-up. Their findings held for both sexes, up to 89, on all four continents. Similar results were observed for mortality brought on by cancer, stroke,coronary heart disease,and respiratory disease.

In terms of weight reduction and improvements in blood lipids and blood pressure, systematic reviews suggest that physical exercise as a supplement to weight-reducing diets may be more beneficial than diets alone. Most RCTs that examined weight loss therapies for adult obesity used low-fat, weight-reduction diets. Hwever, one systematic review found no difference in weight loss between low fat, weight-reducing diets (defined as 30 percent fat) and higher fat, weight-reducing diets10. Low carbohydrate weight-reducing diets were found to be more effective for weight loss than low fat, weight-reducing diets. Adults who are obese may live longer thanks to weight-reduction diets typically low in fat and saturated fat, whether or not they also include exercise.

Numerous behavioral therapies, including diet supervision, exercise regimens, and counseling, have helped obese patients lose weight clinically significantly. However, long-term commitment to lifestyle changes has frequently proved difficult, expensive, and time-consuming. Utilizing technology in the healthcare industry can increase quality and efficiency while also lowering associated costs. The field of technology-based behavioral therapies intended to address certain medical concerns has seen a significant expansion in the use of technical tools like the internet and mobile devices (such as smartphones and iPads). Simple text message reminders to software program support have been…