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OBESITY1Obesity: Pathopharmacological Foundations for Advanced Nursing PracticeWestern Governors University
OBESITY2Obesity: Pathopharmacological Foundations for Advanced Nursing PracticeInvestigated Disease ProcessAccording to the CDC, obesity affected approximately 93.3 million adults in the U.S. between 2015-2016 (CDC, 2019). Obesity is a multifaceted disease process that is defined by a body mass index of 30 or higher. The American Society for Metabolic and Bariatric Surgery (ASMBS) states on its website that, “obesity is considered a multifactorial disease with a strong genetic component. Acting upon a genetic background are a number of hormonal, metabolic, psychological, cultural and behavioral factors that promote fat accumulation and weight gain” (“Disease of Obesity,” 2019). Obesity decreases an individual’s quality of life. The risk for cardiovascular disease, diabetes, certain cancers, and other diseases is just one part of the diseaseprocess; the psychological damage that many patients face is the other. Pathophysiology of ObesityIn August of 2013, the American Medical Association (AMA), officially recognized obesity as a disease. The AMAs decision to put more emphasis on this topic would hopefully aidphysicians and insurance companies in helping to minimize its effects, in years to come. Since 1975, obesity rates have tripled worldwide; 13% of the world’s population is considered obese; 11% are men and 13% are women. According to the World Health Organization (WHO), in 2016, more than 1.9 billion adults over the age of 18 were overweight, 650 million of them were obese; 41 million children, under the age of 5 were considered either overweight or obese. So, what is obesity? It is a BMI or a body mass index of 30 or higher. Simply put, it is consuming more calories or energy than expended. People are eating more and exercising less. This excess adipose tissue or adiposity occurs slowly overtime. The accumulation of lipids like triglycerides, in this adipose, occurs simultaneously as size increases in muscles, organs, and
OBESITY3other tissues. This excess adipose is ten times less efficient than the fat that is stored inside the cell. Obese people have “larger fat and lean mass, higher resting energy expenditure, cardiac output, blood pressure, and greater pancreatic B-cell mass” when compared with a person who isnormal weight (Heymsfield & Wadden, 2017). As a person gains weight, excess lipids become stored throughout the body as adipose tissue in the abdomen and around the organs. This visceral adipose, not only stores lipid but it makes hormones and other materials that contribute to chronic inflammation in the person with obesity. When a person ingests a meal, the glucose, amino acids, and fatty acids in the intestinesstimulate the secretion of insulin by the pancreas. Insulin tells the cells in the body how to act or what to do, such as absorb glucose, fatty acids, amino acids; break down glucose, fatty or amino acids; store glucose store amino or fatty acids (CDC, 2019). Insulin levels affect lipoprotein lipase (LPL) levels in the body.