Evidence Based Practice Research Paper
Obesity is a condition that is characterized by excess body fat. Obesity has significant health effects on both mortality and chronic disease and has raised concern worldwide. The Surgeon General’s “Call for Effort to Prevent and Decrease Overweight and Obesity” in the setting of increasing prevalence, highlights the significance of obesity as a public healthcare problem in the United States. According to the World Health Organization (WHO), it is estimated that there will be 2.1 billion overweight people aged 14 years and above and 900 million obese people in 2018. The cases of obesity are steadily increasing in many parts of the world although a few developed countries, for example, Germany and the United Kingdom have experienced a decrease in the prevalence of obesity in the past decade. Literature research has shown that obesity and overweight are the primary causes of co-morbidities such as cardiovascular disorders, several cancers type II diabetes, and can lead to mortality and morbidity. The cost of health care required to control these complications is substantial (Johnson, Dohrmann, Burt, & Mohadjer, 2014, p, 162).
For example, in the U.S, the total cost needed to treat complications associated with obesity accounts for 1.5% gross domestic product. The Canada, the total direct cost attributable to obesity and overweight is estimated to be 5.5 US dollars, and this figure corresponded to 4.7% of the total expenditure in 2014. In Europe, about 12 billion Euros was used up on overweight, and obesity-related complications in 2014 and relative economic burden ranged from 0.08 to 0.51 of, the national gross domestic product. In China, the cost attributed to obesity-related complications in 2014 was about 2.75 billion US dollars, and these corresponded to 4.1% of the total national medicine costs. Besides, the direct cost has always been shown to increase if related co-morbidities are included (Johnson, Dohrmann, Burt, & Mohadjer, 2014, p, 162). Obesity is usually measured by body mass index (BMI) which is a measure of weight adjusted for height. Body mass index is calculated by dividing kilograms of the weight of an individual by meters of their height squared. However, there are various techniques used to evaluate body fat, the parameters for BMI are easy to measure. Research has shown a big correlation in BMI and body fat in children and adults. Individuals with a BMI of 25 to 29 are identified as overweight, while those with a BMI of above 30 are identified as obese. These limits are grounded on epidemiologic evidence of discernable, then considerable increase in deaths related to obesity cases.
Significance of Overweight and Obesity
Obesity is a risk for many causes of death including diabetes, some cancers, and cardiovascular diseases. Obesity has been associated with many causes of illnesses such as gall bladder disease, osteoarthritis, respiratory impairment and sleep apnea. Conversely, overweight is a risk factor for various cancers including gall bladder cancer, colon cancer, breast cancer, prostate cancer, biliary tract cancer, cancer of the cervix, ovarian cancer, endometrial cancer, and rectal cancer. Overweight is related to concerns of a quality life such as social stigmatization and reduced mobility (Johnson, Dohrmann, Burt, & Mohadjer, 2014, p, 164). The danger associated with specific illnesses tends to increase proportionally with increased BMI than the risk related to the total mortality. Most often, this trend has been demonstrated for cardiovascular diseases. For instance, in a study carried out for a British cohort men the prevalence of major coronary cases was 8.1 per 1,000 individual years for those with a BMI range of 24 to 29. Conversely, coronary heart disease incidence in participants from Framingham was 19 per 1,000 years for men with a BMI range of 23 to 25. In all these cohorts, the susceptibility of developing cardiovascular complication has been seen to increase with the rising range of BMI for men. Similarly, the increase in cardiovascular is seen with the proportional increase of BMI in group studies for women.
Research Evidence Sources
The cases of obesity among U.S adults during 2011-2014 were estimated to be 36.5% (NCSHS, 2015). However, this figure indicated a view about the condition. The prevalence of obesity among adults aged 60 and above (37.0%) and middle-aged adults aged 40-59 was higher than young adults aged 20-39. Another research involved randomized clinical trials (RTC) that included the outcomes of change in BMI. The study compared laparoscopic banding techniques laparoscopic versus open banding techniques in the studies of the effectiveness of surgical intervention for weight loss (NCSHS, 2015).
Wit et al. (2014, p 64) study used 50 obese patients who had a BMI value of over 40. The patients were randomized to either laparoscopic or open adjustable silicone gastric banding. Each of the two groups showed significant average weight drop over one year: 34 kg in the open surgical group and 35 kg in the laparoscopic group. Accordingly, there was a decline BMI in for the open group from 47.9 to 39.3 while in the laparoscopic group there was a drop from 51.4 to 39.5. Complications in the randomized clinical trials included an umbilical hernia (3%), incisional hernias (13.4%) and infection
Non-Research Evidence Sources
The research utilized cohort studies as a non-research evidence source for obesity surgery. Although randomized clinical trials are the preferred form of evidence, this was a situation in which carefully evaluated cohort data were are appropriate. The Swedish Obese Subjects (SOS) research study was employed as the non-research evidence source during the study. The SOS study involved nonrandomized matched controls in which 700 primary health care facilities and 36 universities and county in Sweden. The invasive arm is equally among three surgical methods: gastric bypass, gastric banding and vertical banded gastroplasty (Golubic et al., 2013, p, 405). The controls were treated with non-surgical options available. The data revealed after a duration of two years indicated a drop of 0.5 among the control and 27 kg (23%) among the surgical patients. The percentage drop in weight after vertical banded gastroplasty, gastric banding, and gastric bypass were 23%, 21%, and 32% respectively. Another non-research evidence source which involved 251 patients control patients and 234 patients in the surgical group. The three-year follow-up of data indicated a 20 kg drop in weight among the surgical patient and 0.8 % weight loss in control (James, & Theodore, 2012).
From this review, it is evident that obesity and overweight are a\ common complications that pose a substantial burden to a country. Obese patients can receive modest but clinically weight loss through a range of measures. For instance physical exercise and diet as well as behavioral interventions to modify skills, motivations, and supports associated with physical or dietary patterns. Patients with extreme body mass can be recommended for surgical options. These findings were reached through a variety of source evidence. Randomized clinical trials showed that pharmacotherapy, counseling, can also be used in interventions for obesity and overweight.