Nursing Perspectives: Research and the Front Lines of Obesity
The obesity epidemic affects more than one-third of the U.S. population and cuts across all socio-economic levels. A major risk factor for cardiovascular disease, certain types of cancer, and type 2 diabetes; obesity touches people of all ages, genders and cultures, bringing with it not only physical health consequences but social stigma, embarrassment and psychological insecurities.
This growing problem is also not without economic consequences for both the obese patient and the bedside nurse caring for these individuals. More than $117 billion is spent each year treating obesity related disease conditions, not including direct and indirect costs associated with workplace injuries caused by caring for the obese patient.
As a profession, nursing has long touted patient education and wellness among its key objectives. Not as often stated, yet equally as important, nurses are in a prime position to reverse the obesity epidemic through the generation of evidence-based research. Nurses are expanding the understanding of the biological workings of hormones that affect fat cells and satiety and performing translational research by taking knowledge generated from bench research to interventional studies at the bedside. Nurses are also actively working with communities in Nevada and beyond through participatory research to find ways to sustain healthy lifestyle behaviors.
At UNLV, obesity has become a significant focus of nursing research:
- Associate professor Sally Miller examines the relationship of the hormone ghrelin on eating and physical exercise. Ghrelin is thought to regulate energy balance by inducing hunger at elevated levels. After a meal, ghrelin levels fall as satiety is achieved. But can exercise suppress ghrelin levels and keep hunger at bay? It is hoped that Miller will be able to answer this question upon completion of her data analyses.
- Clinical instructor Jessica Doolen and associate professors Patricia Alpert and Sally Miller conducted a meta-synthesis of research on parental perceptions of obese and overweight children. Their work demonstrated overwhelmingly that parents were not aware their children were overweight or obese. The researchers concluded healthcare providers – including nurses – need to bring parental perceptions into alignment with reality in order to move forward with interventional strategies for these overweight/obese children.
- Assistant professor Alona Angosta studied the weight perception of Filipino adults and found 23 percent of participants thought they were overweight while another 28 percent said they had “fat bellies.” This study is particularly important because it provides insight on a sub-group of the Asian population that is underrepresented in obesity research.
- Alpert and UNLV graduate student Antonio Gutierrez analyzed balance status for individuals defined as normal weight (BMI of 18.5 - < 25), overweight (BMI 25.0 - <30) or obese (> 30). They found overweight adults more likely to have poor balance than normal weight or obese individuals. They concluded balance could be the mainstay for maintaining physical activity and without good balance individuals may be less likely to be active to reduce weight.
Nursing faculty are seeking answers that will one day offer evidence-based interventions to help reverse the obesity problem we face in the U.S. This is no small feat. As nurses uncover solutions to this troubling health dilemma, we hope our study results will find their way into the clinical arena in a timelier manner than the current average – an astounding 17 years.
Strategies to fast track best care practices to the bedside can only occur when research, education and outreach converge. Nursing is uniquely positioned on the front lines of obesity – in all three of these key areas – and therefore it is incumbent upon us as nursing students, clinicians and researchers to engage in the discussion on solutions and do our part to actively make a difference.