Management of Obesity in Primary Care Settings
The prevalence of obesity has reached epidemic levels in the United States and the human and economic toll of this condition is staggering. Besides the adverse effects that obesity has on quality of life in general, the condition is also highly correlated with a number of negative and expensive sequelae, including most especially diabetes and heart disease. While the research into the precise causes of obesity continues, most authorities agree that increasingly sedentary lifestyles and poor diet choices have exacerbated the problem. Likewise, many authorities also agree that primary care settings are the most appropriate for obesity interventions. This study proposes an experimental design in a primary care setting to evaluate the efficacy of an intervention using an activity monitor for a 6-month period in combination with other treatment protocols in reducing body mass index levels. The purpose of this study will be to develop an informed and timely answer to the proposed study's guiding research question, "For adult obese patients in primary care who have a BMI greater than 30kg/meter square (P), does using activity monitors (I), over a period of 6 months (T), produce greater weight loss results (O) compared to obese patients that do not use activity monitors (C)?"
Management of Obesity in Primary Care
On the one hand, innovations in healthcare technologies have nearly doubled the human lifespan over the past 170 years or so, and some authorities believe that American babies born today may live to be 150 years old or perhaps even older (Glor, 2012). On the other hand, though, the prevalence of obesity in the United States has become a serious public health threat that has numerous life-shortening comorbidities such as diabetes and heart disease that threatens to limit life spans among the young and old alike (Overweight and obesity statistics, 2017). Indeed, on average, more than two-thirds of American adults are considered overweight or obese, another one-third of American adults are categorized as obese and one-in-twenty is regarded as extremely obese (Overweight and obesity statistics, 2017). Against this backdrop, identifying cost-effective evidence-based primary care interventions for helping obese people lost weight and keep it off represents a timely and valuable enterprise as discussed further below.
Problem
The prevalence of obesity in the United States, like many other industrialized countries, has experienced a steady increase over the past 10 years together with the numerous adverse healthcare consequences that are associated with overweight and obesity (Sheesley, 2016). For adults aged 20 years and over, obesity is defined as a body mass index (BMI) in excess of 30 (Calculating BMI, 2071). Despite the need for additional research concerning the condition's precise causes, obesity is widely regarded as being a chronic, complex disorder that frequently requires multidisciplinary responses (Sheesley, 2016). There is also a general consensus that primary care is the optimal setting for obesity interventions (Gortmaker & Polacsek, 2015), and these issues form the basis for the purpose of the proposed study as described below.
Purpose
The purpose of the project is to reduce BMI scores among obese adults (BMI >30kg/meter square) by using activity monitors like a pedometer for a 6-month period and comparing these results to a control group that does not use an activity monitor in order to answer the guiding research question set forth below.
Question
The proposed study will be guided by the following research question: "For adult obese patients in primary care who have a BMI greater than 30kg/meter square (P), does using activity monitors (I), over a period of 6 months (T), produce greater weight loss results (O) compared to obese patients that do not use activity monitors (C)?"
Background and Significance
Obesity can cause substantially more complex medical problems for all patients, and may include costly comorbid conditions that can drive the costs of healthcare services up while diminishing the quality of life for patients and their families (Gortmaker & Polacsek, 2015). At present, the economic costs of treating obesity in the United States are around $150 billion a year, but experts caution that even these enormous costs may increase dramatically in the foreseeable future. In this regard, Zomosky (2013) emphasizes that, "Obesity-related healthcare costs could increase by more than 10% in 34 states and by more than 20% in nine states over the next 20 years" (p. 14). Furthermore, a member of the American College of Physicians' Board of Regents warns that, "Obesity is a much harder condition to treat than almost anything...
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