Transcript PTT File

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:
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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
Prevalence Comparison
Health Consequences
• Obesity is related to:
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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
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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
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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%
US vs RCRMC
% Overweight / Obesity Comparison
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
US
RCRMC
Overweight
Obese
Overweight &
Obese
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%)
Patient Education
Percent
None
Elementary
Middle
High
College
Patient Source of Information on
Obesity
50
45
40
35
30
25
20
15
10
5
0
Doctors
Books/Mag
TV
Friends
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
Patient Knowledge on Effects of
Obesity
Patient Knowledge
ty
In
fe
rti
li
en
ou
s
V
O
A
tr o
ke
S
D
M
M
I
Percentage
H
TN
Li
pi
d
100
90
80
70
60
50
40
30
20
10
0
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:
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larger patient sample size
Include ethnicity
Questions on diet intake
A more accurate prevalence can be obtained
from random patient chart review