How Nurse Practitioners Treat Obesity With Sensitivity and Care
Nurse practitioners are changing the lives of patients with obesity through innovative, person-centric treatments.
Health care providers like nurse practitioners (NPs) have made tremendous progress in advancing how obesity is discussed and treated. NPs make it a point to center obesity as a disease — not a personal failing — and as a condition that requires both the buy-in of the individual living with obesity and their health care provider. Fortunately, novel approaches to considering, speaking about and treating obesity are available to all NPs. The American Association of Nurse Practitioners® (AANP) works to provide the latest information on obesity treatments through continuing education (CE) activities, as a topic for podcasts, journal articles and through the creation and curation of an AANP Community solely dedicated to the topic.
Models of Care
NPs are at the forefront of using holistic health care methods to treat their patients, including the Patient-Centered Medical Home Model and Chronic Care Model (CCM). CCM, as “an evidence-based framework aimed toward the prevention and management of chronic disease,” is being utilized in treating obesity. As Barbara Ann Holstein, MSN, FNP, writes in the Journal for Nurse Practitioners (JNP), “NPs, based on their expertise and preparation in patient education, are ideal health care providers to establish partnerships with motivated, informed, chronically ill patients and to promote change in health care policy, guidelines and meeting patient educational needs. Within worksite primary care, NPs can, through the CCM framework, provide chronic disease management and affordable health care access.”
In addition to utilizing different models of care, NPs also take into account social determinants of health (SDoH) when treating patients with obesity. In the Journal of the American Association of Nurse Practitioners (JAANP), Leigh Mullen, DNP, APRN, FNP-C, writes that “screening patients for SDoH allows clinicians to identify those needs and tailor referral efforts.” With SDoH as one framework to understand childhood obesity, she cites a study which “found that if neighborhoods lacked amenities that encouraged physical activity (such as sidewalks, parks, playgrounds, etc.), then the odds for obesity/overweight was 20–45% higher than in neighborhoods with such amenities.”
Utilizing different treatment models and considering SDoH, NPs are seeing progress. By listening to a patient’s concerns and walking them through not just the steps to take but the benefits to reach a healthy weight, NPs accentuate the positives of change. For example, Athena Theodora Samaras, MSN, MPH, RN, PPCNP-BC, writing in JNP, remembers a particular positive encounter she had with a young patient:
“I once cared for an adolescent whose blood pressure was so severely elevated, he needed referrals to cardiology and nephrology specialists to ensure his condition was not affecting his heart or kidneys. In addition to being obese, he had a strong family history of high blood pressure, with nearly every one of his immediate relatives affected. In a busy clinic day, it would have been easy to make these specialist referrals and move on. However, over the course of several monitoring visits, we discussed that, although we cannot control our genetics, we can use lifestyle modifications to prevent long-term health issues. Together, we reviewed evidence-based recommendations.” The quality time his provider made sure to set aside and the education provided made a transformative difference in this patient’s life. “When this patient returned for follow-up several months later, I did not recognize him. Through a healthy diet and lifestyle, he achieved a healthy body mass index, and his blood pressure was under control. In reviewing his cardiology visit note, I was struck by how it noted that the patient attributed this improbable success to the education provided by his primary care provider.”
New Frontiers of Technology and Medication
What role do technology and pharmaceutical breakthroughs play in treating patients with obesity? In the article “Promoting Physical Activity in Clinical Practice Through Wearable Technology” in JAANP, the authors note that “the negative health consequences of physical inactivity continue to be a global problem that must be addressed from the highest levels of government down to local primary care providers.”
In their study, they considered the usefulness of fitness wearables and mobile health trackers. While the authors note that, “fitness trackers seem to incentivize physical activity across various demographics, limitations remain regarding the validity and reliability of certain metrics for multiple devices.” Their conclusion is that “fitness wearables and phone apps can be a catalyst for lifestyle behavior change and for cultivating a stronger health care partnership between the patient and their provider.”
Weight-loss medications are another evergreen topic between patients and health care providers. On a forthcoming episode of AANP’s podcast NP Pulse: The Voice of the Nurse Practitioner® set for release at the end of March, guest Johnnie Sue Wijewardane, Ph.D., FNP-BC, FAANP, speaks candidly about her personal experiences with trying to lose weight — from experimenting with fad diets to a final, successful combination of surgery and weight loss medication. But as Wijewardane explains, what worked for her may not work for every patient. Even with her training, she had to try a number of approaches until one fit and allowed her to thrive and keep weight off.
More Resources Related to Obesity
AANP’s CE Center contains many resources devoted to understanding and combatting obesity. NPs interested in technology (like a continuous glucose monitor) will want to take in “Integrating Technology into Obesity Treatment,” while the current course of the month — “Physical Activity and Nutrition: Building Blocks in Obesity Care” — presented by AANP Obesity Specialty Practice Group co-chair Rebecca J. Graves, Ph.D., NP-C, is available for no charge until March 1. Find even more CE related to obesity management at AANP’s CE Center.