FNU 527 Adult Weight Management
October 3, 2013
Your essay should be typed in Times New Roman 12-point font. Answer the questions in question format (i.e numbering and answering the questions).
1. 1) Among waist circumference, BMI, waist-to-height ratio, and waist-to-hip ratio, what is a better screening tool to identify a risk factor of obesity, cardiovascular disease, and other chronic diseases?
BMI (body mass index) has been used as a prevalent screening tool for obesity. However, recent studies found that individuals with larger adiposity lead to have greater risk of diabetes and other cardiovascular risk factors. The studies showed that measurement of central ...view middle of the document...
I would also recommend her to start paying attention to her diet such as portion size, composition of meal, replacing saturated and trans fats with mono- and poly- unsaturated fats to prevent further storing of excess adipose tissue.
According to her anthropometric data, she has excess adiposity even though she has normal BMI (24.7). She has waist circumference of 36â€ (normal level >35â€), hip circumference of 40â€ (normal level >35â€), 54.55% of WHtR ((WC (40â€)/Height (66â€))*100)), which categorized in seriously overweight/obese, and waist-to-hip ratio of 0.9 (WC (40â€)/HC (36â€)), which determined to be higher risk for women. Those data indicates her risk for type 2 diabetes, high blood pressure, high cholesterol, and heart disease. In her situation, she has higher risk especially for type 2 diabetes and cardiovascular disease because of her family history of grandfather with CVD and her father with type 2 diabetes. I consider an immediate intervention for her to lose excess adiposity by exercise and diet for decreasing the risk of type 2 diabetes and CVD.
2. Susie Q is a 45 year-old bank teller, mother of two teen-age children, with type 2 diabetes for two years. She has been referred to your clinic by her MD to improve her blood glucose control and reduce her lipid levels.
She has a blood glucose meter but does not use it. Susie has no current exercise pattern. Her husband, employed by the Post Office, bought her an exercise bike a few years ago when she was trying to lose weight, but she rarely uses it. She eats out with husband and daughters 2 times a week, usually at a local pizza parlor or other fast food. She usually has a glass of wine or beer with dinner in a restaurant. She uses no supplements or other meds.
Susie has a high school education and has attended community college. She is concerned about the possibility of taking insulin and is afraid of complications from her diabetes. Susie says she is eager to improve her lifestyle in order to manage her diabetes.
Height 64 in weight 190 lb
BMI 33 BP 127/79 mmHg
A1c 13% FBG 240 mg/dl
T-cholesterol 252 mg/dl LDL-C 155 mg/dl
HDL-C 48 mg/dl 2-hr Post prandial BG 220 mg/dl
Tryglycerides 335 mg/dl Pre-prandial BG 255 mg/dl
1) What counseling strategies would you use and why? Support your answer.
I would use behavioral therapy to alternate her diet and lifestyle. Behavioral therapy focuses on the principles and techniques to modify eating and activity behaviors. She is ready to make a change to improve her lifestyle to put her diabetes under control. Thus, behavioral therapy would be more effective for her since it provides the use of behavioral modification techniques concentrating on self-monitoring, goal setting, stress management, stimulus control, problem solving, cognitive restructuring and relapse prevention. Especially self-monitoring, goal...