The Person, Health and Wellbeing

Table of Contents

Introduction.

Discussion.

Conclusion.

Reference list

Introduction to The Science of Obesity Management

Lifestyle modulation often provides an individual a better health and a better active life as well. Obesity in the recent time has been figured out as one of the very usual health issues which is majorly tagged with the food habit and lifestyle of people. The same factor has been identified for Rebecca, a patient with 150 kg weight, admitted for TKR (Total Knee Replacement). Lifestyle of the patient has a direct contribution to her obeysed condition. The study outlines the implementation of transtheoretical models for lifestyle modification within evidence-based frameworks. The purpose of the study is to implement a motivational interview to initiate the patient to change her behaviour.

Discussion on The Science of Obesity Management

In the introductory section, it has been mentioned that obesity is one of the major health problems which is noticed among the majority. As per the official report, 63.4% of the entire population Australia was identified as obeysed or overweight for 2015, which has increased to 67% (The Department of Health, 2019). 12.5 millions of people in Australia suffer from the same issue and Rebecca is one of them with 150 kg body weight. As per the case study, Rebecca has mentioned to the registered nurse that she loves food and consumer foods with high fat content. She has further added that she consumes food in the time of psychological stress, worry or sadness. The medical report of the NHS has pusb lined paper on the addition of foods with high calorie content. As per the official report, the reward pathway of the brain is often stimulated with the food of high sugar and fat content. Hence, withdrawal or sudden restriction on the consumption of such food invokes craving. From this angler, it can be analysed that addition is often associated with the calorie content of the food and this is prominently identified by pinpointing the behaviour of Rebecca towards her food.

As per the viewpoint of Lewis et al. (2019), obesity management program and training for lifestyle modification and patient education helps in the reduction of the clinical issue of overweight among the patients in the community level. However, Bray et al. (2018) has argued the fact and mentioned that there is a lack of initiative among the obysed patients to get into the training programme for weight reduction. The application of motivational interview (MI) and training programs helps the patients to modify lifestyle. As per the case study of Rebecca, the patient should be associated with a motivational interview programme to change her lifestyle.

The change of habit or practice of an individual is analysed with the transtheoretical model. Saunders et al. (2016) has mentioned that the model has multiple stages namely, precontemplation, contemplation along with preparation, action, maintenance and termination. Friman, Huck & Olsson (2017) has contradicted and has included a stage of relapse in the transtheoretical model between maintenance and precontemplation and has represented the model as a cyclic one. The condition of Rebecca has been analysed by a registered nurse and it has been noticed that she has an intention to change her eating habit. Hence, she is in the third stage , that is, preparation, as per the transtheoretical model of change (as in case study).

There is only 1 week to motivate Rebecca with MI and this will trigger the patient to move onto the next stage, that is, Action. Lindson‐Hawley, Thompson & Begh (2015) has mentioned that MI is a counselling approach which helps a patient to be motivated for behavioural change and this has been developed by Miller and Rollnick. In this case, the application of the major four principles of MI should be done for planning the MI session for Rebecca. The official website of RFP has mentioned the four principles with the Acronym called RULE, in which R is righting reflex resistance, U for understanding of patients motivation, L for listening and E for empowerment (apf, 2012).

Firstly the words of the patient should be listed carefully and the guidance should be analysed as well. This will help to identify the level of motivation and the agent of motivation in the life of the patient. This factor needs to be exploited to further motivate the patient and this will help the patient to move into the action stage of the transtheoretical model of change.

 On the other hand, the fact of righting reflex is also pinned with the MI programme. Miller & Rose (2015) has stated that the importance of good health and the right path to achieve the same is the goal over which the principle of writing reflex of MI has been standardised. In this case, the adverse effect of obesity should be explained to Rebecca and the benefit of fitness should also be included. As per the viewpoint of Rezaeipour & Apanasenko (2018), excess body weight for fat deposition imparts tremendous pressure over the bones, joints, and knee and specifically on the valves of veins. Additionally, in this context Onyemaechi et al. (2016) has added that spine problem and hip joint problem is also associated with the issue of overweight which turns down activity of a person. Excess fat deposition even invokes the issue of varicose vein. All these factors should be included in the section of information sharing, which will help the patient to get the importance of good health and weight minimisation. The patient has recently been admitted for TKR surgery and it should be explained to her that the degeneration of the strength of kee has happened for her to be overweight. This should certainly act as a motivational cue for her to get into the stage of action.

MI always prioritises the autonomy of the patient in the process of management of the personal habits. In this case also, autonomy and freedom should be provided to Rebecca for management of her behaviour. This will address the principle of patient empowerment. psychological support and the way of transformation of the eating habit should be explained to her.

A routine plan for the daily schedule of the patient is needed to be outlined by prioritising the liking and disliking of Rebecca. As the patient has TKR, heavy exercise should be avoided. However, light physical activities like relaxed walking, household activities should be encouraged. As per the idea of Karami et al. (2018), diet plan has a major contribution behind the minimisation of body fat and weight for an individual. This helps the patient to achieve the goal in a non-surgical method. Starvation or food gaps should be managed strictly and no skip of meals should be allowed. Low calorie foods and low carb diet should be emphasised. The intake of fruits will be encouraged along with a lean protein diet. As per the idea of Holm et al. (2016), lean protein diet includes fish, chicken which is always healthy for an overweight patient. Rice should be replaced with quinoa in meals and low calorie soup should be taken. Green peas, baked beans or barley should be consumed along with whole grains. This will help the patient to get fibrous foods.

Certain things are needed to be avoided during the interactive session of MI. No pressure should be created over the patient regarding the change of her habit of eating and sudden abstains from high caloric food also be avoided. This may impart negative influence over the motivation level of the patient regarding the modification of lifestyle. As per the viewpoint of Friman, Huck & Olsson (2017), any kind of negative input triggers withdrawal of an individual from the process of behavioural change. Hence, it can be mentioned that any kind of negative thoughts regarding the outcome of the behavioural change should be rejected, during the regular session of MI. No such ruined work or food be included in the schedule which is associated with the chronic illness of the patient. Hence a routine check-up should be started and association of chronic disease (if any) for the paint is needed to be done.

The plan should be done in such a way that it can be continued after the discharge of the patient. This can be continued to progress in the modulation of the eating behaviour of the patient. The obesity and weight of Rebecca indicates that her body has a tendency of high absorption of fat. Hence, the aspect or maintenance is highly needed and absolute termination should not be included in the lifestyle management plan. However, some leniency may be provided after a certain stage.

Conclusion on The Science of Obesity Management

At the end of the study, tt can be concluded that Rebecca is in the stage of preparation in the transtheoretical model of change management. Hence, there is a basic level of motion within the mind of the patient. This can be further instigated with the implementation of MI. The key principles like patient education, empowerment, listening and understanding of motivation should be implemented to further motivate Rebecca to change her eating habit. The habit of high calorie diet consumption should be replaced with that of low caloric food and fibrous food. However, abrupt abstains from caloric diet may invoke relapse of the previous habit. This should be unmanaged with effort planning.

Reference List for The Science of Obesity Management

The Department of Health, (2019). Overweight and Obesity. Retrieved on 25 September 2020, from:https://www1.health.gov.au/internet/main/publishing.nsf/Content/Overweight-and-Obesity#:~:text=In%202017%2D18%2C%20the%20Australian,63.4%25%20in%202014%2D15.&text=The%20Department%20of%20Health%20implements,to%20tackle%20obesity%20in%20Australia.

Lewis, E., Huang, H. C. C., Hassmén, P., Welvaert, M., & Pumpa, K. L. (2019). Adding Telephone and Text Support to an Obesity Management Program Improves Behavioral Adherence and Clinical Outcomes. A Randomized Controlled Crossover Trial. International Journal of Behavioral Medicine26(6), 580-590. Retrieved on 25 September 2020, from: https://link.springer.com/article/10.1007/s12529-019-09815-1

Bray, G. A., Heisel, W. E., Afshin, A., Jensen, M. D., Dietz, W. H., Long, M., ... & Hu, F. B. (2018). The science of obesity management: an endocrine society scientific statement. Endocrine reviews39(2), 79-132. Retrieved on 25 September 2020, from: https://academic.oup.com/edrv/article-abstract/39/2/79/4922247

Saunders, G. H., Frederick, M. T., Silverman, S. C., Nielsen, C., & Laplante-Lévesque, A. (2016). Description of adults seeking hearing help for the first time according to two health behavior change approaches: Transtheoretical model (stages of change) and health belief model. Ear and hearing37(3), 324-333. Retrieved on 25 September 2020, from: https://www.ingentaconnect.com/content/wk/aud/2016/00000037/00000003/art00016

Friman, M., Huck, J., & Olsson, L. E. (2017). Transtheoretical model of change during travel behavior interventions: An integrative review. International journal of environmental research and public health14(6), 581. Retrieved on 25 September 2020, from: https://www.mdpi.com/1660-4601/14/6/581

Lindson‐Hawley, N., Thompson, T. P., & Begh, R. (2015). Motivational interviewing for smoking cessation. Cochrane Database of Systematic Reviews, (3), 554-5567. Retrieved on 25 September 2020, from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006936.pub3/abstract

Miller, W. R., & Rose, G. S. (2015). Motivational interviewing and decisional balance: contrasting responses to client ambivalence. Behavioural and cognitive psychotherapy43(2), 129-141. Retrieved on 25 September 2020, from: https://www.cambridge.org/core/journals/behavioural-and-cognitive-psychotherapy/article/motivational-interviewing-and-decisional-balance-contrasting-responses-to-client-ambivalence/74496E66A2D5625296F9B2EEE805B359

Rezaeipour, M., & Apanasenko, G. L. (2018). Effects of overweight and obesity on postural stability of aging females. Middle East J Rehabil Health Stud5(4), e81617. Retrieved on 25 September 2020, from: https://www.sid.ir/FileServer/JE/50011220180406

Onyemaechi, N. O., Anyanwu, G. E., Obikili, E. N., Onwuasoigwe, O., & Nwankwo, O. E. (2016). Impact of overweight and obesity on the musculoskeletal system using lumbosacral angles. Patient preference and adherence10, 291. Retrieved on 25 September 2020, from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792212/

Karami, A., Dahl, A. A., Turner-McGrievy, G., Kharrazi, H., & Shaw Jr, G. (2018). Characterizing diabetes, diet, exercise, and obesity comments on Twitter. International Journal of Information Management38(1), 1-6. Retrieved on 25 September 2020, from: https://www.sciencedirect.com/science/article/pii/S0268401217306126

Holm, J. B., Rønnevik, A., Tastesen, H. S., Fjære, E., Fauske, K. R., Liisberg, U., ... & Liaset, B. (2016). Diet-induced obesity, energy metabolism and gut microbiota in C57BL/6J mice fed Western diets based on lean seafood or lean meat mixtures. The Journal of Nutritional Biochemistry31, 127-136. Retrieved on 25 September 2020, from: https://www.sciencedirect.com/science/article/pii/S0955286316000255

Friman, M., Huck, J., & Olsson, L. E. (2017). Transtheoretical model of change during travel behavior interventions: An integrative review. International journal of environmental research and public health14(6), 581. Retrieved on 25 September 2020, from: https://www.mdpi.com/1660-4601/14/6/581

apf, (2012). Psychological strategies Retrieved on 25 September 2020, from: https://www.racgp.org.au/afp/2012/september/motivational-interviewing-techniques/

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