Physiology Case Study

Patient Case Study Analysis. Management of Obesity Essay
A patient case study analysis is an outline of diagnosis and the ongoing treatment. The patient, in this case, will be called Mr. P, who is a 24-year old male, 6.0 feet tall, and weighs 280 pounds. As per the height and weight, he has a body mass index (BMI) of 38, which, according to clinical standards, indicates obesity. A normal BMI ranges from 24-29.9; anything above 30 is considered obese. Mr. P has been experiencing increased heart rate for quite a while and fears that his body fat might be the primary cause. According to the medical protocol, he needs to lower his BMI to achieve a normal heartbeat, improve his self-esteem, and acquire the desired body shape.

Obesity is one of the most common health concerns among the youth. In the United States, the rise of the condition among youngsters is associated with the decline in physical activity. Research shows that young people spend most of their time indoors engaged in the Internet (Heymsfield & Wadden, 2017). According to Sanyaolu et al. (2019), around 1.9 billion adult individuals globally are overweight. Also, over 340 million children and adolescents aged 5-19 have the same condition. The disease is life-threatening; it results from excessive fat accumulation in the body that may impair well-being, increase the risk of cardiovascular ailment, type 2 diabetes, and high blood pressure, among other illnesses.

Mr. P’s current pressing medical issue is the rise in his heartbeat, which has negatively impacted his usual daily activities. It weighs his body down because he cannot walk like he used to; he cannot lift heavy things. Additionally, he reveals that his weight has affected him psychologically. His health condition is accompanied by low self-esteem, poor body image, and inability to partake in various activities like his peers, for instance, sports. Further, his love life has been adversely impacted by the excessive eight, and his relationships always end based on his condition, which demoralizes him.

The Basal Energy Expenditure (BEE)
BEE is the amount of energy adequate to cover all movement and bodily activities essential for a living thing to survive for a day, given in kcal/day or kJ/day. The calculation will consider moderate stress level, and this is because Mr. P’s emotional status has not yet affected his everyday functioning. The BEE will also include light daily undertakings like walking and less engaging house chores. He can only do minor things, not anything that involves heavy lifting or high-energy use.

For men,

B.E.E. = 66.5 + (13.75 x kg) + (5.003 x cm) – (6.775 x age)

66.5 + (13.75 x 127) + (5.003 x 182.88) – (6.775 x 24)

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66.5+1746.25+ 914.94-162.6= 2565.09

B.E.E= 2565 kcal/d

Comparison of Basic Energy Requirements (Calories) with Nutritional Intake
Mr. P’s condition is not severe, so he uses the normal feeding process, enteral feeding. It refers to food intake via the gastrointestinal (GI) tract through the mouth, esophagus, stomach, and intestines. To calculate his daily caloric requirement, it will consider the Basal Metabolic Rate (BMR), the number of power individuals requires in relaxing. BMR incorporates up to sixty to seventy percent of the energy consumed daily (Howell & Kones, 2017). One of the most precise approaches to approximating the BMR rate is through the Harris-Benedict formula. After getting the BMR, it will be multiplied with the level of activity an individual engages in; with Mr. P, it will be the sedentary category which indicates little or no exercises, which equals 1.2.

Adult male: 66 + (6.3 x body weight in lbs.) + (12.9 x height in inches) – (6.8 x age) = BMR

Daily caloric requirement = BMR x 1.2

66 + (6.3 x 280) + (12.9 x 72) – (6.8 x 24)

66 + (1764) + (928.8) – (163.2)

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66 + 1764 + 928.8 -163.2= 2595.6

BMR=2596

Caloric requirement = 2596 x 1.2 =3115.2

The daily calorie needs for my client = 3115

Mr. P’s Current Daily Nutritional Intake and Calorie Value
Breakfast
1 glass of chocolate milk= 208
5 slices of bread 75 calories per slice =375
3 fried eggs=300
Lunch
1 place of rice = 272
Cooked bean=200
1 cup of mixed vegetables= 118
500ml soda= 203
Four o’clock snack
1 cup of tea= 82
50g slice of cookie= 250
Dinner
Pizza 4 slices = 1140
1 slice of chicken = 239
1 beer = 154
The total daily calorie consumption for my client is approximately 3541.

The Patient’s Nutritional Needs
Mr. P wants to reduce weight; changing his diet will be the primary treatment approach towards achieving his treatment goals. The main aim will be to reduce carbohydrates, fats, and sugars, which are the major contributors to energy. Therapy will then increase the intake of proteins, vegetables, fruits, and water. Fruits and vegetables contain low-calorie content, while proteins will help activate high metabolism levels for the system to shade accumulated body fat. According to the calculations above, Mr. P is taking more calories than his body requires. To decrease his accumulated fats, he needs to lower his calorie intake than what the body needs to ensure that the metabolic process burns extra body fat.

Effective treatment needs to incorporate appropriate nutrition and exercise, which are the best methods to weight loss within short periods. Nutritionists advise that lowering carbohydrates consumption by 1,000 calories daily, the equivalent of 2Ibs weekly, might be harmful and can cause adverse effects by interfering with digestion. Shading 2Ibs and higher has a probability of decreasing muscles, which lowers BMR. Denying the body of the nutrients it needs, which has severe detrimental impacts, and losing kilos this way is unsustainable (Howell & Kones, 2017). Also, while reducing calorie intake, it is vital to sustaining the rates of fiber consumption and other dietary requirements to stabilize the body’s necessities.

Research has confirmed that many people choose to reduce their calorie intake by 500 kcal per day to achieve weight loss. The famous worldly formula for healthy weight reduction is burning 3,500 calories to lose 1 pound or 0.45kgs in a week. Mr. P’s energy need per day is 3115 while he is taking approximately 3541. With the above formula, though the researchers argue it is dangerous for one to lose 1000 calories per day, it is not the case for Mr. P because he is taking extra food, and only reducing 1000 energy will help him achieve his therapeutic objectives (Howell & Kones, 2017). The treatment goal is to maintain a 2541 nutritional intake under the normal range of 2,800-3,000 for men in his age group.

Mr. P has a table consisting of food daily intake, including high levels of carbohydrates, sugars, and fats intake. In this part, the eating timetable reduces starches, sugars, fats and increases protein, vegetables, fruits, and water intake to maintain 2541 calories daily. If the patient follows the program to the latter, he will lose 7000 Cal in one week, equivalent to 2 pounds. Though the recommended is 3500 per week, our main reason for 1000 is because Mr. P is currently taking more food than his body requires. Mr. P will try this formula for two weeks; if it affects his health, he will retrieve it to 500 Cal in a day.

Breakfast
1 glass of chocolate milk= 208
3 slices of bread 75 calories per slice = 225
3 fried eggs=300
1 cup of vegetables= 118
Lunch
1 place of rice = 272
Cooked bean=200
1 cup of mixed vegetables= 118
1 banana and 1 apple = 225
Four o’clock snack
Oatmeal porridge= 339
Dinner
Vegetables = 118
1 slice of chicken = 239
2 apples= 190
2liters of water throughout the day
Total daily intake will be approximately 2552

Conclusion
Studies have shown that obesity is one of the health issues causing many physical and psychological pains. Through nutrition, many people have been able to improve their conditions and beat the disease. Calculating the BEE, BMR, and caloric needs and documenting daily food intake is the only way to monitor whether nutrition works for specific patients. Mr. P will also engage in exercise, walking for a start since he cannot do major exercise. Discipline is critical in using a diet to reduce body fats; the patient must avoid foods they like that are not necessary for the body.

References
Heymsfield, S. B., & Wadden, T. A. (2017). Mechanisms, pathophysiology, and management of obesity. New England Journal of Medicine, 376(3), 254-266, Web.

Howell, S., & Kones, R. (2017). “Calories in, calories out” and macronutrient intake: the hope, hype, and science of calories. American Journal of Physiology-Endocrinology and Metabolism, 313:608–612, Web.

Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and adolescent obesity in the United States: A public health concern. Global Pediatric Health, 6, Web.