Essay Health And Health Promotion PDF

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Essay Health And Health Promotion...

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Essay: Health And Health Promotion Services available and Health Promotion

Health Promotion plays an important role in providing ways to tackle obesity. Providing appropriate information may help to educate not only a target group of people but a whole society. NICE (2014) provides guidance regarding obesity assessment and management and also prevention. The Government has recognised the importance of promoting health regarding obesity by developing an advice-giving role in front-line health professionals such as General Practitioners or pharmacies (that usually lack confidence to promote health) by providing appropriate information to help patients to access the health services available in order to make lifestyle changes needed (food choice and exercise)(Faculty of Public Health FPH2008).

Government recommendations such as ”5 a day “, “The Eat well guide” provide information regarding the benefits of eating fruits and vegetables as well if healthy types of food to support a balanced diet.

“NHS weight loss plan”, “Change4life”, “Couch to 5K “, “OneYou” offer support and promotes losing weight in a healthier and safe manner not only through diet but also through exercises (Public Health England 2015). Furthermore, programs such as “Start active, stay active: info graphics on physical activity“ “School food standards” along with the “eat-well plate” are addressed for children due to the prevalence of obesity among this group. By tackling obesity at this level, the government aiming to break down the vicious circle of unhealthy diet and lifestyle for obese children to reduce further consequences of obesity as well to change the life expectancy. The above programs are available from GP or online on NHS Choices website. The “NHS weigh loss plan“ was reported to be downloaded from the NHS website over 2 million times (NHS 2015a). Furthermore, for more complex cases, the GPs may offer other alternative options for losing weight such as medication or bariatric surgery (NHS 2016).

Energy balance in obesity implies reducing the food intake and increasing the physical activity with the aim to lose weight. Evidence shows that dietary interventions need to be addressed primarily such as hypo-caloric diets combined with water consumption (Dennis et al 2010). In addition, physical activity such as walking during the day or using stairs rather than taking the lift, is supporting the dietary interventions to lose weight (Wadden et al 2012).

Cuba (NHS 2015b) represents an example of reversing the obesity effect. The negative consequence was reflected in the economical drop, however the positive outcome was reflected in population loosing weight with an average of 5.5 kg /person. Despite the economical crisis that they experienced, there was also recorded a decreased rate of morbidity and mortality. In conclusion, government intervention such as creating an environment that promotes and encourages the population to live healthier is required; individual requirements refer to healthy eating and increased level of physical activity(ibid).

Obesity Consequences

The management of obesity is required to prevent and reduce the consequences of obesity, such as physical, psychological, social and financial. Obesity can increase the risk of coronary heart disease, high blood pressure, stroke, type 2 diabetes, cancer, fertility problems and non-alcoholic fatty liver disease (NAFLD)(More-life 2014). In addition, feeling tired constantly, sweating, joint or back-pain or struggling during normal activities such as walking, are some of the physical consequences of obesity. Furthermore, the life expectancy is reduced by an average between 3 to 10 years (NHS Choices 2014).

From a psychological perspective, Obesity may cause depression, anxiety, low self-esteem, isolation and low quality of life. According to the English Longitudinal Study of Ageing (ELSA 2015), a connection was established between stigmatization against obese people and psychological impact on their well-being. People who experienced negative attitude against their weight reported depressive symptoms,

impact on quality of life as well as on life satisfaction. Therefore, reducing stigmatization may reduce the impact on the well-being of obese people. Moreover, obesity and stigmatisation may have a negative impact on individual’s happiness, especially among women (Latif 2014).

From a social perspective, obesity may impact on an individual by narrowing their options in terms of friends, relationships, employment and quality of life. Discrimination and stigmatization may occur in the workplace, in the media, retail, educational and even in healthcare, including doctors, nurses, trainee dietitians, nutritionists (Swift et al 2013), and medical students (Pantenburg et al 2012).

Stigma in Healthcare System

Health professionals need to be appropriately trained and educated regarding obesity in order to manage it effectively (Swift et al 2013). Providing dignity in care, including a positive attitude, language the presence of bariatric furniture and providing health advice will impact

on patient positively and humiliation and stigmatisation will consequently be avoided (Thomas & Lee-Fong 2010). Communication techniques such as providing appropriate information regarding the benefits of a healthy lifestyle, including diet and physical activity, without focusing on the obesity or loosing weight will also help not to offend the patient. The stigmatization attitudes of healthcare professionals were based on preconceived ideas that obesity is the result of excess intake of food without considering any underlying conditions or genetic factors that may cause an uncontrolled overweight (Moleres et al 2013).

Person-centred Care (National Institute for Health and Care Excellence (NICE 2011) is not followed by health professionals as they focus on the patient 's condition namely obesity rather than the patient himself. Additionally, according to The Code of Conduct (NMC 2015) health professionals must adhere to a non judgemental attitude as stereotyping and discrimination is against the law. However, patients reported to be treated disrespectfully and not treated as human beings (Phelan et al 2015). Weight Bias is an impediment to appreciate a person in a holistic way considering their character,

personality, intelligence, social role, physical or mental health (Obesity Society 2016). In addition, labelling them as lazy or lacking self control, difficult or complex patient indicating a poor level of knowledge around obesity and how to offer information by promoting healthy eating or the benefits of engaging in different physical activities, they may lack communication skills while providing the information (Flint 2015).

Terminology used by healthcare professionals towards obese patients to describe the excess of weight including words such as “fat”, “morbidly obese” and “obese” was reported to be the most undesirable words while unhealthy weight and overweight was reported to be the most motivating words. Furthermore, patients that are experiencing the embarrassment and language stigmatization disclosed that they may cancel a further appointment to avoid further humiliation (Puhl et al 2013).

Size-appropriate equipment for patients dealing with weight problems is needed in order to avoid discrimination. In clinical settings, this

equipment is called bariatric and refers to the treatment of obesity; furnishings such as chairs for waiting rooms, bariatric beds, equipment such as scales, blood pressure cuffs, examination gowns, shower chair, bariatric wheelchair, lifting equipment and appropriate techniques for moving and handling should be readily available to access without it seeming that this type of equipment is rarely used (Thomas & Lee-Fong 2010). However, the bariatric equipment has been reported to be beneficial for both patients and staff for safety reasons and to improve dignity in care, reducing the embarrassment and humiliation among obese patients (ibid). It was reported that stigmatisation was reduced after students were exposed during training to a video about obesity. However, this only had a short term effect (Poustchi et al 2013) .

Inequalities in the health care system are affecting obese people as well. Iacobucci (2016) state that Obese patients are denied surgery such as knee or hip operations based on their BMI and some of the NHS Trusts are asking obese patients to lose weight prior to having any interventions, arguing that the extra adipose tissue may hinder the healing process (Pierpont et al 2013) which may also result in an

increase cost to the NHS. However, this restriction is conflicting the national clinical guidance.

According to the Royal College of Surgeons (2014), the postcode lottery is influencing the availability of treatment for obese people due to the lack of appropriate services such as bariatric surgery, depending on geographical location despite the acute need. The benefits of bariatric surgery such as the remission of diabetes type 2, are well known, however, the statistics show that the bariatric surgical interventions recorded a decrease of 10% in defiance of the continue raising of the obesity rate (Kmietowicz 2010). Patients with BMI below 50 but above 40 and without a life-threatening condition such as diabetes or stroke are not considered by some of the NHS Trusts in the need for a referral for bariatric surgery. The explanation for this may be a different interpretation of the Nice guidance (Ibid). Furthermore, the restriction for bariatric surgery and the promotion of loosing weight is claimed by some of the NHS Trusts for financial reasons (Royal College of Surgeons 2016). A recent research argues that bariatric surgery is a cost effective, especially for patients with type 2 diabetes that are no longer requiring medication for diabetes

after this intervention and the savings for one patient over the lifetime were estimated to be around £95 000 (Kmietowicz 2016). Therefore, not offering referrals for bariatric surgery where appropriate, only promoting loosing weight programs through lifestyle changing and dietary intervention is a form of discrimination against obese people.

The burden of obesity is affection the whole society and non-obese people may have a negative attitude against obese people (Puhl & Heuer 2010). On the other hand Dr Sarah Jackson (2015) from University College London (UCL), sustained that there is no law to protect obese people against discrimination such as there is for age, sex, religion, race, disability or sexual orientation, stated in the Equality Act (2010), and this may explain the inappropriate attitude towards obese people. Furthermore, shaming obese people will increase the stress and does not encourage them to lose weight.

Conclusion

Obesity affects equally individuals and society. The consequences of obesity impact on the individual from all angles: physical, psychological social and economical. On the other hand the costs of obesity affect the entire society as may limit the employment status, becoming dependent on benefits and experiencing poverty. Simultaneously, obese people face discrimination, stigmatisation and stereotyping. This will impact most of the time negatively on an individual 's emotional state. Heath Promotion is recognised to be a key to tackling overweight patients. The management of obesity is required also for financial reasons. Accessing all kinds of services, especially health services involve extra costs which are only treating the effect or providing comfort rather than to treat the cause.

The need for acknowledging a lifestyle change while living a very busy and stressful life, including the job demand, children, travelling and the lack of time as well as facing the lack of exercise. Obese people face stigmatization and negative attitude. Weight gain can make people lose their confidence, self-esteem; usually an individual 's failure, whether it is in love or professional is attributed to the excess weight. After experiencing discrimination, obese people

became isolated and find the comfort in eating eliminates the anxiety or depression created. Other emotional conditions such as stress are triggers for eating unhealthy or to increase the amount or the frequency.

As was shown, obesity stigma is reducing the care and dignity provided to patients in health care settings . This may include the lack of knowledge about obesity and how to approach it, negative attitude, stereotyping language or the lack of facilities and equipment needed for bariatric patients. Obesity is a significant modifiable risk for morbidity and mortality and it 's management is required in order to provide treatment simultaneously for other conditions. The desperate need for appropriately educated health professionals in the primary care and clinical setting in regards to the need to care for obese people, including health promotion by explaining the benefits of a healthy lifestyle as well as the risks of the unhealthy lifestyle....