Understanding obesity health associated problems: Finding solutions in weight management
From experience experts are in agreement that understanding obesity health associated problems is very important if any meaningful solution is to be arrived at. This is because being obese or overweight is a major cause of health discomforts including dyspnea, exercise intolerance, functional limitation, disability, and impaired quality of life. The following physiological conditions impair exercise tolerance:
- Anxiety
- Cardiac impairment as a result of myocardial ischemia; pulmonary or systemic hypertension
- Circulatory impairment (claudication, microvascular disease, or both)
- Exaggerated cardiorespiratory response to exercise
- High metabolic (oxygen) cost to perform modest exercise
- Increased metabolic rate relative to lean body mass
- Mechanical inefficiency
- Musculoskeletal disturbances
- Pulmonary function and gas exchange derangements
- Reduced respiratory muscle strength
Understanding obesity health associated problems: Regular exercise
Regular exercise is a crucial component of weight loss intervention programs. Exercise training, more so when put together with calorie restriction, can lead to decreased body weight and fat, increased fat-free mass, improved strength and endurance, and improved aerobic fitness. However, traditional weight loss programs are generally not configured to meet the needs of morbidly obese people or obese patients with gas exchange impairments or respiratory failure.
Doctor Dalal Akoury MD, President and founder of AWAREmed Health and Wellness Resource Center is reiterating that comprehensive pulmonary rehabilitation is better suited to meet these complex needs, utilizing its components of exercise training (including recommendations for long-term adherence), collaborative self-management education, nutrition counseling, and psychological support for anxiety and depression while closely monitoring the patient’s respiratory status. It is however important to note that the pulmonary rehabilitation can lead to lower body weight and improved functional status and health status in obese patients.
Understanding obesity health associated problems: Pulmonary rehabilitation goals
Goals of pulmonary rehabilitation for obese people with respiratory impairment include the following:
- Acclimatization to or optimization of use of CPAP or BiPAP
- Decreased disability and return to ADLs, hobbies, and work
- Increased exercise tolerance
- Increased self-efficacy
- Optimal utilization of assistive equipment (related to mobility, self-care, and hygiene), home care services, and outpatient resources
- Weight loss
Additional special considerations apply to the rehabilitation of people with morbid obesity and people with severe obesity with concomitant lower-extremity musculoskeletal disturbances. In general, such rehabilitation requires special equipment that can accommodate people of extreme weight. Morbidly obese people may not be able to use standard exercise equipment such as cycle ergometers and treadmills. Staff members must be familiar with the weight limits of the equipment in their programs. Walking, low-impact aerobics, and water-based activities are suitable forms of aerobic exercise for these patients. Recumbent bicycles, bariatric walkers, quad canes, commodes, wheelchairs, lifts, scales, and beds specially designed for obese people are commercially available. Extra staff may be needed to assist the morbidly obese patient with ambulation, transfers, stair climbing, and bed mobility. Extra-wide chairs that can accommodate extra weight should be available.
Understanding obesity health associated problems: Finding solutions in weight management
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