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Obese Patient: A Case Study

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Overview
Obesity in terms of measurement is a body mass index (BMI) of greater than 30. Health care professionals and most individuals understand obesity has many implications on one’s health. It is estimated that 78 million, nearly 36% of Americans, are obese (Yanovski & Yanovski, 2015). In a stark contrast, given the number of obese people in the US, approximately only 2.74 million patients were reported to use any type of obesity medications (Shinn & Gadde, 2013). Many barriers exist as to why there is such a small percentage of participants using any form of antiobesity medication: safety concerns, costs, limited efficacy, participants reluctance to view obesity as a diagnosis that would require medical intervention (Shin & Gadde, 2013). …show more content…

Mayo Clinic gives the example of a patient weighing 200 pounds and being labeled obese according to BMI standards; this patient would only need to shed 6 to 10 pounds to begin noticing small yet beneficial health improvements (Mayo Clinic, 2015). The National Institutes of Health (NIH) stated that with a reduction of 10% of body weight, obese patients will lower their risk in developing additional medical conditions such as high blood pressure, type 2 diabetes, high cholesterol, while making a positive change in their overall health (Vivus, 2012). There is a never ending supply of articles, websites, fitness magazines, nutritional supplement companies, gym memberships, workout videos, recipes for reducing caloric intake, counseling programs, hypnotists, support groups, and surgical interventions that all address reducing weight. For the sake of this topic, this paper will address pharmacological interventions as a way for weight reduction, what medications are currently being used as well as a new drug combination of phentermine and topiramate (Qsymia) being used for the treatment of …show more content…

A 56-week trial with 1267 randomized participants having a BMI > 35 (Shin & Gadde, 2013). Participants did not have significan comorbidities and were treated with either a low-dose PHEN/TPM (3.7/23mg), full-dose PHEN/TPM (15/92mg), or placebo (Shinn & Gadde, 2013).
Group 3. The largest of the clinical trails, had 2487 participants either overweight or obese with a recorded BMI of 27 – 45 and having 2 or more obesity related comorbidities: hypertension, type 2 diabetes, dyslipidemia, abdominal obesity, or prediabetes (Shin & Gadde, 2013). Shin & Gadde identified the five main concerns the FDA focused of during the course of the PHEN/TPM trial: teratogenicity, cardiovascular, cognitive, psychiatric and metabolic acidosis (2013). In regards to teratogenicity, there are reports indentifying a higher chance of cleft lip and cleft palates among infants whose mother’s had taken TPM during her pregnancy (Shin & Gadde, 2013). Another concern regarding TPM is that there may be interference with oral contraceptives, which may lead to the failure of the contraceptive protection (Shin & Gadde, 2013). In this trial there was a small increase in heart rate of participants between .6 and 1.6 bpm and there was not an increase in major adverse cardiac events when comparing PHEN/TPM and the placebo (Shinn & Gadde,

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