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Date of Award

12-8-2021

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Thesis Committee Chairperson

Wencan Lu, DNP, FNP, RN

Second Reader

Matthew S. Rossen, DMD, MD

Keywords

obesity, obese, primary care, patients, lifestyle management, weight loss, nutrition, exercise, nurse practitioner, intervention

Abstract

Clinical Problem: Obesity is a multifaceted disease that affects the lives of millions of Americans each year. Obesity can lead to a plethora of other conditions, such as diabetes, heart disease, and certain types of cancer. Primary care practices can intercept patients suffering from obesity by identifying the problem and urging lifestyle changes; however, there is a lack of continuity of follow-up with regard to patients with obesity, which can lead to patients experiencing apathy, a lack of motivation, and a decrease in successful weight loss and lifestyle modifications.

Significance: The burden that obesity causes is vast, including the strain on the healthcare system as well as the sequelae of physical and emotional implications for patients and their families. According to the Center for Disease Control (CDC), the projected U.S. healthcare expenditure for obesity-related conditions is roughly $147 billion annually (2021). Furthermore, obesity increases the risks of developing a wide array of serious physical illnesses, such as hypertension, diabetes, ischemic heart disease, cerebrovascular accidents, and certain forms of cancer. Increased rates of depression are also associated with obesity (Gearon et al., 2020).

PICOT Question: This evidence-based proposal is intended to answer the question, “In patients with obesity, does a primary care nutrition and lifestyle management program help achieve weight loss and healthy lifestyle modifications?”

Clinical Change: Through a nurse practitioner-led nutrition and lifestyle change program, patients suffering from obesity could receive the support and guidance needed to be successful in losing weight and leading healthier lives. With this program, which will provide follow-up care and appointments, patients could be monitored periodically instead of relying on yearly physical assessments to address further concerns. Weight loss helps to mitigate the severity or risks of developing conditions such as heart disease and diabetes, which can lead to overall improvement of health, fewer complications, and fewer hospitalizations.

Desired Outcome: The desired outcome of the proposed clinical change is to achieve weight reduction of 5% of total body weight as well as an increase in physical activity and adoption of healthy lifestyle modifications in patients with obesity in the primary care setting.

Summary: Reviewing the literature and available evidence indicated that lifestyle management and nutrition programs for patients with obesity are underutilized in the primary care setting. This evidence-based proposal demonstrates a plan for implementation of a lifestyle-based, nurse practitioner-led program that focuses on nutrition and exercise counseling and periodic weigh-ins in order to reduce the impact of obesity on primary care patients.

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