Treating Obesity in Mental Health Care Settings Research Paper

Pages: 20 (5949 words)  ·  Style: APA  ·  Bibliography Sources: 23  ·  File: .docx  ·  Level: Doctorate  ·  Topic: Health - Nursing  ·  Written: January 27, 2020

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Defined as a BMI of 30 or greater, the prevalence of obesity among all American adults increased from less than one-quarter (23%) in 1990 to 31% by 2001, and these increases were experienced across all racial, ethnic and age groups for American men and women (Simon et al., 2006). The data from 2013 to 2014 also indicate significant prevalence levels for obesity among American adults, including the following findings by the National Institute of Diabetes and Digestive and Kidney Diseases:
  • More than 2 in 3 adults (70.2 percent) were considered to be overweight or have obesity;
  • About 1 in 3 adults (32.5 percent) were considered to be overweight;
  • More than 1 in 3 adults (37.7 percent) were considered to have obesity;
  • About 1 in 13 adults (7.7 percent) were considered to have extreme obesity;
  • More than 1 in 3 (38.7 percent) of men, and about 1 in 4 (26.5 percent) of women were considered to be overweight;
  • Obesity was higher in women (about 40 percent) than men (35 percent);
  • Extreme obesity was higher in women (9.9 percent) than men (5.5 percent); and,
  • Almost 3 in 4 men (73.7 percent) were considered to be overweight or have obesity; and about 2 in 3 women (66.9) were considered to be overweight or have obesity (Overweight & obesity statistics, 2020, para. 6).
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Despite major advances in health care and medical technologies in recent years that hold the promise of increased longevity for Americans in the future, the prevalence of obesity may offset these gains unless and until efficacious interventions are developed and implemented across the country (Simon et al., 2006). For example, Bacon & Farnworth (2012) emphasize that, “Given the expected increases in diabetes, cardiovascular disease, and other adverse consequences of obesity, increasing obesity rates are expected to produce an unprecedented decline in life expectancy in the United States” (p. 62).

Research Paper on Treating Obesity in Mental Health Care Settings Assignment

Some indication of the historic trends that have been experienced with obesity in the United States can be discerned from the relevant statistical data that are depicted graphically in Figure 2 below. Although the National Institute of Mental Health and the U.S. Centers for Disease Control and Prevention do not report statistics specifically on the proposed study’s targeted population of 20 to 55-year-old overweight/obese adult patients, the overall increase in adults aged 20 years and over can be extrapolated from these trends.

Figure 2. Trends in adult overweight, obesity and extreme obesity among American adults: 1960-1962 and 2013-2014

Source: Overweight & Obesity Statistics at https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity

As can be seen from the trends depicted in Figure 1 above, while the number of overweight American men and women held essentially steady during the period from 1960 through 2014, the numbers of obese men and women aged 20 to 55 years overall experienced sustained and steady growth during this period. Likewise, the statistics concerning mental disorders are equally alarming. For example, according to the U.S. National Association of Mental Illness:
  • 1 in 5 American adults experience a mental illness at some point during their lives;
  • Nearly 1 in 25 (10 million) American adults live with a serious mental illness;
  • One-half of all chronic mental illness begins by age 14 years and three-quarters by the age of 24 years (Mental health facts in America, 2020, p. 1).
Not surprisingly, these trends have also resulted in some significant health care costs as well and these issues are discussed below.

Health Care Cost

Overall, the costs that are associated with the additional health care burden that are directly attributable to obesity in the United States currently exceed a staggering $147 billion each year, and the health care costs for obese consumers are $1,429 higher compared to those for people with normal weight (Adult obesity facts, 2020). Furthermore, these costs represent a significant increase from just a few years ago. In this regard, according to a white paper published by the American Nurse Practitioner Foundation (2013), “The medical costs associated with obesity in the United States in 1995 were estimated at $79 billion; by 2008, obesity-associated medical costs had risen to an estimated $147 billion” (Nurse practitioners and the prevention and treatment of adult obesity, p. 1). Further, in 2008, the health care costs for treating obesity were estimated to be $1,429 higher for obese individuals compared to normally weighted individuals (Nurse practitioners and the prevention and treatment of adult obesity, 2013).

More recently, these costs have also experienced an across-the-board increase. For example, the average expenditures for individual health care consumers for the treatment of obesity in 2013 are set forth in Table 1 below.

Table 1

Increases in annual individual medical expenditures due to obesity and a one unit increase in BMI for different groups of adults

Sample

Total expenditures

Third party expenditures

BMI $ (SE)

Obesity $ (SE)

BMI $ (SE)

Obesity $ (SE)

Total (N?=?31,591)

197 (43)

3429 (799)

180 (41)

3210 (793)

Males (N?=?12,349)

244 (94)

3565 (1437)

225 (87)

3395 (1381)

Females (N?=?19,242)

179 (59)

3359 (804)

164 (38)

3116 (783)

White (N?=?12,895)

144 (59)

2557 (1173)

134 (54)

2454 (1084)

Non-White (N?=?18,696)

261 (71)

4086 (1050)

240 (70)

3799 (1034)

Private insurance (N?=?19,384)

216 (53)

3846 (1077)

199 (51)

3581 (1041)

Medicaid (N?=?4464)

182 (102)

2954 (1711)

170 (96)

2809 (1633)

Uninsured (N?=?7152)

91 (51)

1689 (922)

N/A

N/A

Source: Biener, Cawley & Meyerhoefer, 2017, p. 7

The data set forth in ?Table 1 above indicates that obesity increases the health care costs of adults by an average of $3,429 (in 2013 dollars) (Biener et al., 2017).

Likewise, the health care costs of treating mental health disorders are also significant and on the rise, amounting to $71 billion to treat depressive disorders alone (the most expensive category of mental health disorders), trailing only the costs to treat diabetes mellitus ($101.4 billion), ischemic heart disease ($88.1 billion), low back and neck pain ($87.6 billion), hypertension ($83.9 billion) and injuries due to falls ($76.3 billion) in terms of health care costs nationwide (Winerman, 2017).

These enormous costs are expected to continue to increase well into the foreseeable future unless efficacious interventions are developed and implemented for all demographic groups, including those health care consumers suffering from a combination of mental health disorders and obesity. These costs also mean that advanced practice registered nurses have an important role to play in weight management initiatives and these issues are discussed below.

Supporting Evidence for Advanced Practice Registered Nursing

Although there has been some modest progress made in recent years with respect to the awareness of obesity among health care consumers suffering from mental health disorders, the problem is still “relatively invisible in mental health contexts” (Ashley, 2015, p. 3). According to a white paper by the American Nurse Practitioner Foundation (ANPF) (2013), advanced practice registered nurses in particular can help motivate obese individuals to lose weight and keep it off. In this regard, the ANPF reports that, “Initially, patients might not be ready to lose weight and may require that ongoing assessment and support. The [advanced practice nurse] might need to have discussions about the importance of weight loss at more than one visit, while being sensitive to the patient’s readiness and/or ability to change” (Nurse practitioners and the prevention and treatment of adult obesity, p. 8).

Here again, although every patient’s experience is unique, there are some common strategies that are available that can help motivate obese people to initiate and adhere to a daily physical fitness regimen. For instance, the ANPF adds that, “A number of strategies can facilitate patient motivation. One recommended strategy is to facilitate the patient in identifying at least one compelling and personal reason to lose weight” (p. 8). Some typical examples of these types of individual reasons that may have varying levels of relevance for obese individuals with mental health disorders include the following:
  • Decreasing the risk of a complicated pregnancy;
  • Being able to keep up with or play with children or grandchildren;
  • Walking without losing one’s breath; or,
  • Preventing further chronic diseases (Nurse practitioners and the prevention and treatment of adult obesity, 2013, p. 8).
In many instances, obese patients desperately want and need information concerning how they can prevent the adverse consequences of obesity, and advanced practice nurses are in a good position to provide this information in a culturally sensitive fashion (Nurse practitioners and the prevention and treatment of adult obesity, 2013). Therefore, regardless of the treatment setting, it is vitally important for advanced practice registered nurses to take the initiative and introduce evidence-based interventions… [END OF PREVIEW] . . . READ MORE

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