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Senior Research Project. Obesity By Peter Cheng. Introduction. Obesity is becoming a major health concern in our nation due to following 3 reasons: - Prevalence increasing each year - associated w/ many chronic diseases - healthcare cost of obesity is rising each year. Prevalence.
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Senior Research Project Obesity By Peter Cheng
Introduction • Obesity is becoming a major health concern in our nation due to following 3 reasons: - Prevalence increasing each year - associated w/ many chronic diseases - healthcare cost of obesity is rising each year
Prevalence • National Health and Nutrition Examination Survey (NHANES) conducted 4 studies: • NHANES I: 1971-1974 • NHANES II: 1976-1980 • NHANES III: 1988-1994 • NHANES 1999-2000
NHANES Results • NHANES II • 47 % of US population overweight/obese • NHANES III • 56 % of US population overweight/obese • NHANES 1999-2000 • 64 % of US population overweight/obese
Health Consequences • Obesity is related to: • Cardiovascular: CAD, stroke, HTN • Endocrine: DM2, Dyslipidemia, Infertility • Resp: sleep apnea • GI: gallstones • MS: OA • cancer (endometrial, breast, prostate, colon)
Health Consequences • Each year 300,000 people die of obesity related diseases • Making it the 2nd leading cause of preventable death, just behind smoking
Healthcare Cost • Imagine the amount of time, effort, and money we put in each day in FCC treating pts w/ DM, HTN, lipid • Center of Disease & Control released a report stating that in 2003, cost of obesity related healthcare expenditure was: 75 billion dollars
Research Objective • Prevalence of obesity in our pt population • Perception of these pts on their obesity • What pts are doing for their obesity • Patient’s level of knowledge on obesity • Ideal way of outreach without offending pts
Method • A questionaire was randomly given to FCC patient, after our nurses record their medical record numer, age, sex, weight, and height • Exclude pts under age 20 over over 80 • No abbreviations were used on questionaire
Questionaire: stats • Age • Sex • Weight • Height
Perception • Do you think you are overweight? • What do you think your ideal weight is?
What are pts doing • On average, how many hrs per wk do you exercise? • What kind of exercises do you do the most? - run, walk, swim, bike, rollerskate, basketball, aerobics, weighttrainning, others
What are pts doing: cont • Have you tried to lose weight before? • If you tried to lose wt before, what was the most amount of wt that you were able to lose? • If you were to lose weight, which method are you willing to use consistently? • Diet, exercise, meds, herbal products, surgery
Pt Knowledge • What is your education background? • Which of the following conditions do you think is associated with obesity? • DM2, HTN, OA, Strokes, MI, infertility, dyslipidemia, venous insufficeincy, anemia, bad vision
Pt knowledge: cont • Do you think Americans in general are becoming more overweight than before? • Do you think that obesity is an important health issue in our society? • What do you think causes obesity? Genetic, diet, lack of exercise, others
Info and Outreach • Where do you get the most information about weight lose from? • Your doctor, books/mags, TV infomercials, friends, others • Do you feel offended when your doctor tells you that you have to lose weight?
Info and Outreach: cont • Would you like to learn more about obesity and weight loss from your doctor? • What do you think your doctor can do to help you lose weight? - oral Instructions, handouts/pamphlets, medications, others
Result • General figures: • Number of Patient: 101 • Age: range 23-71, average of 51 • Sex: male 28 (28%), female 73 (72%)
Prevalence of Obesity • Avg height: 63.98 • Avg weight: 194.5 • Average BMI: 33.32
Prevalence of Obesity • Prevalence of pt overweight (BMI 25-29.9) • 27% • Prevalence of pt obese (BMI >30) • 53% • Prevalence of pt overweight/obese (BMI>25) • 80%
Prevalence • Prevalence of overweight/obesity in male • 84% • Prevalence of overweight/obesity in female • 80%
Pt’s own perception • Do overweight pts know that they are overweight? • Ideal weight difference: - Pt’s own ideal weight minus their true ideal weight (using BMI of 25): even if they know they are overweight, do they know by how much?
Pt’s own perception • of those who are overweight: • 82% of pt think they are overweight (BMI: 37) • 18% of pt thinks that they are NOT overweight (BMI: 31)
Pt’s own ideal weight • Patient’s own ideal weight comes out to BMI of 26
What pts are doing • Exercises: • avg 2 hrs/wk • Walk (65%), Bike (11%), swim (8 %), wt training (5%), gardening (4%), aerobics (3%), Run (1%), basketball (1%), play with pets (1%)
What pts are doing • 78% of pt tried to lose wt, 22% did not • Those who tried to lose wt, max amount of wt lost was average of 25.7 pounds • If pt was to lose wt, they prefer: - 64% prefer exercise, 61% prefer diet, 20% prefer medication, 15% prefer herbal products, and 15% prefer surgery
Pt knowledge on Obesity • Education - none (6%), elementary (13%), middle school (14%), high school (47%), College of above (21%)
Pt knowledge on Obesity • More Americans are obese than ever? • 7% says No • 93% says Yes • Is obesity an important health issue? • 7% says No • 93% says Yes
Pt knowledge on Obesity • Obesity can cause which? • DM (38%), HTN (40%), OA (18%), stroke (30%), MI (39%), infertility (8%), dyslipidemia (49%), venous insuff (9%), anemia (4%), vision (7%) • Number of pt who got all of them right: 1
Pt knowledge on cause of obesity • What is the cause of obesity: • 43% says genetic, 67% says diet, 82% says lack of exerciseds • Only 26% of pt think it is all three factors
Outreach Preference • Are you offended when your doctor tell you to loose weight? • 98%: No • 2%: Yes • Would you like to learn more about obesity from your doctor? • 17 %: No • 83 % : Yes
Outreach Preferences • What do you think your doctor can do to help you lose weight? 73 • Oral instructions: 58% • Handout/pamphlets: 49% • Medications: 40%
Conclusion • Prevalence of obesity among RCRMC pt population is significantly higher than national average • 82% vs 64% • Average BMI of our pt population: 33.3
Conclusion • Majority of overweight pts know that they are overweight; however they underestimate the amount of weight loss they need • The average of patient’s own ideal weight is BMI of 26
Conclusion • Our patient population do not have enough exercise hours: • Only 2 hrs per wk
Conclusion • 68% of pt have education high school or above, yet their knowledge of obesity are still very lacking. More than ½ of them do not realize the important health implications of obesity.
Conclusion • Vast majority of pts are NOT offended when doctors tell them to lose weight; in fact, they would like to learn more about weight loss from their doctors.
Discussion • What can be contributing to obesity in pts? • Patients do not know their true ideal weight • They don’t know the long term health implications of obesity, thus they lack motivation • They do not know the correct method to lose weight • They just can’t/won’t start diet & exercise
Discussion • What can we do to better serve our patients? • Patients are more receptive than we think; they want to know more about losing weight • Discuss with them their ideal weight • Educate pts on health consequences of obesity • Go into more detail about what to do with diet and how much exercises they need
Discussion • What can be improved on this study: • larger patient sample size • Include ethnicity • Questions on diet intake • A more accurate prevalence can be obtained from random patient chart review