Obesity has rapidly become one of the leading threats to public health in America. Today, according to data in the 2014 State of Obesity, an annual report prepared by the Trust for America’s Health and the Robert Wood Johnson Foundation, more than one-third of Americans are obese, and an additional third are overweight.
While data indicate the obesity rate is stabilizing, the epidemic of obesity still holds far-reaching implications for healthcare and nursing in America, standing as a leading predictor of a range of other health problems and causes of preventable deaths.
Rachel Centeno, BSN, RN, CBN, has worked as a nurse for more than two decades and has served as the bariatric nurse coordinator at The Johns Hopkins Center for Bariatric Surgery in Baltimore for the past five years. She answers questions below about a nurse’s role in working with patients who are obese.
Q: What motivated you to become interested in helping people deal with obesity?
A: I’ve always had a passion for teaching health, wellness and fitness since I was in college. I had the opportunity five years ago to combine my passion with my nursing career. I’ve enjoyed working with surgical patients, and I am able to utilize my nursing skills and educate patients and the community. I appreciate that the obesity population has a unique challenge, and I enjoy being part of their lives when they make a commitment to change their lives.
Q: Obesity is a hot topic today. What threats does obesity pose, aside from personal or community health?
A: The obesity epidemic affects healthcare costs and the economy. It has affected the work force by costing them money for healthcare costs and lost time from work related to diseases and health issues associated with obesity.
Q: How would you say the arrow is pointed in terms of responding to or alleviating America’s obesity epidemic?
A: It’s complex. Awareness has improved, and there are more programs in place in addressing the issue. However, obesity is still on the rise. The culture makes it very difficult. “Supersize America” is the culture. Portions have increased. The good news is that many fast food chains are offering healthier options. But there are mixed messages. TV commercials target unhealthy foods. Childhood obesity is worsening, and adolescents who are obese are likely to be obese adults. The rise in technology has caused a decrease in physical activity. Society has very busy families who are always on the go, and they turn to quick foods such as fast foods and processed foods. The short answer is that it’s better in some ways; however, it’s worse in other ways.
Q: What have you found to be helpful tools and strategies for nurses to employ to help patients address obesity?
A: Awareness and education is the key. Outreach to the community and physicians has been very helpful. But the population in general still is unaware of the negative effects of obesity. As nurses, we can fill the role of advocate and support person. It’s important for nurses to know that obese patients can be treated. If they decide to go forward with surgery, they can be optimized. Often times, those in the obese population do not seek healthcare for many reasons, including embarrassment. This population continues to have a stigma with society, as well as in the healthcare field. Sensitivity training has improved the attitudes of the healthcare team.
Q: How do you believe the recent emphasis on health and nutrition among many in the population has actually affected the obesity epidemic?
A: Awareness has increased. However, obesity continues to be on the rise. The health and nutrition emphasis seems to have targeted those who can afford it. The young and underprivileged still remain uneducated and without resources. The culture needs to be more proactive in preventing obesity.
Q: How have bariatric procedures helped, if at all?
A: Bariatric surgery has improved the lives of many. Those who have had the surgery have lived longer because their diseases have been resolved or improved. Many studies are showing the benefits of bariatric surgery are significant.
Q: What are key things for nurses to remember when working with patients who have undergone bariatric surgical procedures?
A: Education specific to taking care of these patients is important. Safety is priority. These patients are higher-risk surgical patients. The most significant complication with these procedures is an anastomotic leak, which is associated with a fever, increased heart rate and anxiety.
Q: What kinds of procedures, techniques and developments are promising for combating obesity now and in the years to come?
A: Bariatric surgery has come a long way and continues to improve. Long-term studies are showing the benefits, and outcomes have been improving as more research is being done. There are numerous experimental treatments. However, gastric bypass has been the gold standard of treatment. The sleeve gastrectomy procedure is the most popular procedure at this time. It does not involve malabsorption, and the research is showing that it’s a very effective procedure for long-term weight loss.
Q: What can nurses do to improve fitness among their own ranks and in the general population?
A: Continue to educate themselves on the effects of obesity. Act as role models. Educating the community will also help the general population. As a nursing profession, society will look to us for guidance and as a resource.