Potential Health Risks for Obesity

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1 Describe the clinical manifestations present in Mr. C.
Mr. C has been suffering from obesity, probably since he was young. Based on his history, he gained around one hundred pounds in the last two to three years. According to the Center for Disease Control and Prevention (2021), his body-mass index (BMI) coincides with the long-standing history of obesity.
The patient has difficulty breathing with an increased respiratory rate at 26 cpm, apnea during sleep and dyspnea on activity, bipedal edema, and pruritus for six months. The physical examination revealed that the patient has a high blood pressure at 172/98 mmHg, which is a consequence of increased peripheral vascular resistance secondary to narrowing the arteries due to increased fat deposition in obese individuals. This is supported by an increase in cholesterol and triglyceride levels. All of these are complications of obesity (Mayo Clinic, 2020). The high BUN and serum creatinine shows affectation of the renal system (Healthwise Staff, 2020).
2 Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
Kinlen et al. (2018) discussed that obese patients have higher mortality rates than non-obese patients. This was the finding in the Framingheart Study, which illustrated that both genders, aged forty years, non-smoker, and obese live 5.8 (male) and 7.1 (females) are less than the people with normal BMI.
Some of the health risks include: 1) Diabetes mellitus may be a consequence of impaired glucose tolerance.; 2) Hypertension, cardiovascular diseases, and cerebrovascular diseases may be secondary to atherosclerotic plaque formation that deposits on the blood vessel wall, decreasing the luminal diameter. This leads to increased vascular resistance, resulting in a higher BP.; 3) Dyslipidemia results in high LDL and VLDL, and low HDL.; 4) Metabolic syndrome affects the endocrine system, and it is a consequence of central obesity and insulin resistance; 5) Gastrointestinal problems, such as gastroesophageal reflux disease and cholestasis, show a higher predisposition in obese individuals; 6) Psychosocial problems (Kinlen et al., 2018).
These must be considered when thinking of bariatric surgery because some of its complications are as follows: 1) Nutritional deficiency due to celiac disease. The patient already lacks proper diet and nutrition.; 2) GERD and stomach ulcers and strictures. Obesity increases hyperacidity, but bariatric surgery has been found to result or aggravate GERD. Additionally, obesity already posed a risk for GIT problems, and bariatric surgery might contribute to the formation of new GIT diseases; 3) Gallstones are predominant in obese patients who rapidly lost weight.; 4) Cardiopulmonary problems, such as deep vein thrombosis (DVT) and embolism (Kostecka & Bojanowska, 2017). 5) It has been found to have short- to mid-term benefits in terms of dyslipidemia. However, long-term effects are questionable (Climent et al., 2020).
3 Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems you can identify from the functional health patterns and provide the rationale for each.
First, Mr. C’s nutritional intake poses a problem because he stated that obesity had been his problem since he was young, and recently, he even gained more weight. Second, he will have difficulty exercising because he already has dyspnea on exertion. This may reflect cardiorespiratory, muscular problems, and deconditioning (Kinlen et al., 2018). Third, the sleep-rest cycle is affected due to apnea. Specifically, the patient is probably experiencing obstructive sleep apnea (OSA), which is caused by the narrowing of the airways secondary to increased pressure brought by enhanced fat deposition. This can also lead to hypoxia, which might affect the function of the organs (Jehan et al., 2017). Fourth, health management will be complex due to multiple comorbidities. Furthermore, lastly, the patient will have metabolic problems because central obesity is linked to insulin resistance, leading to endocrinologic issues (Kinlen et al., 2018).
4 Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
The staging of ESRD is based on the estimated glomerular filtration rate (eGFR). The stages are 1, 2, 3a, 3b, 4, and 5, with the eGFR of 90, 60 to89, 45-59, 30-44, 15 to 29, and less than 15, respectively. The contributing factors that must be considered are the diet (i.e., foods high in salt, protein, and potassium), smoking and alcohol use, high BP, older age, and insulin resistance (Mayo Clinic, 2019).
5 Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. to prevent future events, health restoration, and avoidance of deterioration of renal status.
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