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into motion with several support groups and a healthcare team to manage and support the patient.A nutritionist can educate the patient on weekly bases for dietary choices. A personal trainer can help start an exercise program to fit the patient's goals and physical ability. Several insurances inthe State of Utah have obesity help and support groups. PEHP has a program called "Waist Away” and Select Med an insurance for Intermountain Health Care (IHC), has “Live Well.” These programs have different levels of support and education for patients from; healthy BMI patients to stay healthy, to extreme obese patients with healthcare support consisting of nurses, dieticians, physicians, physicians assistants or nurse practitioners, exercise physiologist and several other support care people. All of these practices of care are in line with the national guidelines outlined from the AACE, the healthy people 2020 goals, and the goals of several different organizations to prevent morbidity and decrease mortality such as The American Heart Association, the diabetic foundation, and many others.(AACE, 2014)A3. Managed Disease ProcessAn obese patient managed disease process would first have the BMI decrease to a healthylevel over the amount of time a physician deems appropriate for that patient. Second would be tomaintain a healthy BMI through regular exercise, nutrition and follow-up with the primary care physician or manager of their plan for obesity. A coping patient will also be healthy mentally. Several disease processes take a toll on a patient’s mental status through depression or anxiety. Having a component in the patient's goals to deal with this can help a patient reach and maintain their goals. Keeping either a food journal or another type of journal to record the progress made and the work it took to get there will help a patient stay on this journey and not relapse into poor choices. Discussing triggers that lead to poor food choices is another way to manage this disease
PATHOPHARMACOLOGICAL FOUNDATIONS11process along with joining support groups to help overcome emotions. Keeping doctor appointments is a must to follow up if the patient is taking prescribed medications or after weight-loss surgery. Realizing weight loss is ongoing and will take time to change a lifestyle along with doing the things mentioned above would keep a patient healthy and increase their life expectancy. A3a. DisparitiesCertain ethnicities are at a higher risk for obesity due to dietary intake choices, access to healthy foods, and their cultural and environment. Genetics play a significant role in patients who are obese with obese parents. Another disparity is access to health care, transportation and knowledge base for exercise. African American and Latino populations have the highest rate of obesity compared to Caucasian people. This may be due to the decrease in average income rate, environment or living arrangements. More African American families and Latino families live inapartment buildings with several families and access to parks may be limited. They tend to live