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The patient’s family members should support and encourage the patient to make these important lifestyle modifications. In many instances, the family members may themselves have to make lifestyle changes in order to help and support the patient. Support could also come in the form of patient groups at the weight loss clinic, where the patient can discuss feelings, successes, and setbacks with other patients in the same situation. Unmanaged Disease FactorsThe absence of critical factors can make obesity unmanageable for some patients, including access to care. Patients in rural communities or those lacking in primary care facilities may find it difficult to begin treatment. Other patients may have a primary care physician but must travel far distances in order to see specialists or consult with weight loss clinics. When access to care is not easily accessible, the patient may be hindered from seeking treatment, and may wait until their condition becomes severe or life-threatening. The absence of health insurance may also make obesity unmanageable for the patient. The cost of treatment for obesity can be high, especially when brand-name pharmaceuticals or bariatric surgery is involved. Comorbidities associated with obesity also add to the cost of treatment. A patient without insurance would most likely have a difficult time affording the necessary care plan. Furthermore, if the patient has insurance that has a very high deductible or does not cover the treatment ordered, the patient may also be unable to manage the disease effectively.
EFFECTS OF OBESITY21The absence of a good support system may also make it difficult for the obese patient to manage their disease. Conflict and resistance from family members could be detrimental to the treatment program. Family members who challenge the treatment plan by tempting the patient with unhealthy foods or who encourage sedentary behaviors may cause problems for the patient. Some family members may enable to patient with old, harmful behaviors. Other obese patients may feel isolated without a support system and be unable to stick to the care plan. Unmanaged Disease CharacteristicsAn obese patient who is not effectively managing their disease will present with several characteristics. They will appear overweight, have high waist and hip circumferences, have a large amount of visceral fat, and have a BMI of 30 or greater (Medscape, 2018). They may also have rashes from skin-on-skin friction, hirsutism in women, acanthosis nigricans, and skin tags, which are common with insulin resistance secondary to obesity. Some patients may have joint deformities from excess weight, along with osteoarthritis and pressure ulcers, and may have trouble with mobility. Other symptoms may stem from obesity itself or from comorbidities.