Care of the Obese in Advanced Practice Nursing

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Care of the Obese in Advanced Practice Nursing

SKU# 9780826123572

Communication, Assessment, and Treatment

Author: Lisa L.M. Maher DNP, ARNP, FNP-BC


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This book is the first resource to give the APN the practical tools with which to communicate, assess, and treat obese patients. Designed to help APNseasily broach an uncomfortable topic, the book walks practitioners through the exam, providing tips on effective communication, understanding lifestyleconstraints, and working with the patient to improve his or her condition without shame. Emphasizing multidisciplinary approaches and evidence-basedtreatment, the book addresses prevention, provider recognition, and treatment of adult and pediatric obesity with the goal of improving overall quality oflife.

This resource offers practical information on diet and exercise to foster healthy weight loss along with psychological, pharmacological, and surgicalrecommendations. Effective tips on all facets of working with obese patients, bolstered with real-life examples that provide the patient’s perspective,will help APNs understand and provide high-quality care to these vulnerable patients. Additionally, the book includes substantial information oncomorbidities, which add to the complexity of obesity treatment. Chapters address current trends and causes of obesity; communication “dos” and “don’ts”;the technical aspects of obesity, including genetics and pathophysiology; treatment of addiction and eating disorders; assessment from the APN point ofview; disease management; pharmacological, surgical, and medical management; and costs and insurance coverage. Tools that can be used to enhance clinicalpractice are featured in the Appendices.


  • Written specifically for the advanced practice nurse
  • Covers all facets of communication, assessment, and treatment
  • Includes case studies and treatment plans designed specifically for nurses
  • Highlights a multidisciplinary approach
  • Includes effective tips, photographs, and real-life examples that will benefit both provider and patient

Product Details 

  • Publication Date December 02, 2015
  • Page Count 400
  • Product Form Paperback / softback
  • ISBN 13 9780826123572

About The Author(s) 

Lisa L. M. Maher, DNP, ARNP, FNP-BC, received her BS in wellness from Waldorf College in Forest City, Iowa, in 2003, her BSN from Allen College in Waterloo, Iowa, in 2005, and her MSN from Graceland University in Independence, Missouri, in 2008. In 2011, she received her DNP from the University of Iowa in Iowa City. She is board certified as a family nurse practitioner (FNP) through the American Nurses Credentialing Center (ANCC). She is the current president of the Cedar Valley (Iowa) chapter of Preventive Cardiovascular Nurses Association (PCNA) in Waterloo, Iowa.

Dr. Maher has been employed as a nurse practitioner (NP) at the Cedar Valley Cardiovascular Center since 2008. She specializes in treatment of general cardiology, sleep apnea, weight loss, and risk factor modification. She started the Cedar Valley Center for Lifestyle Medicine Clinic in 2008 and the Cedar Valley Cardiovascular Center Sleep Clinic in 2009.

Table of Contents 





1. Obesity: The Epidemic, Trends, and Causes

The Epidemic



2. Definition of Obesity and Obesity Terms

3. The Many Roles of the Advanced Practice Nurse

Certified Nurse Practitioner (CNP)

Certified Registered Nurse Anesthetist (CRNA)

Certified Nurse-Midwife (CNM)

Clinical Nurse Specialist (CNS)

Case Study 1


4. Addressing Pediatric Obesity

Risk Factors

Growth Charts

The Provider–Pediatric Patient Relationship

5. How to Initiate the Weight Conversation With Patients

Weight Discrimination—Provider

Weight Discrimination—Patient

The Provider–Patient Relationship

Therapeutic Communication

Ethical Principles

Addressing Legal Issues—Malpractice

6. Patients’ Stories

Case Study 2


7. Overview of Genetics and Pathophysiology of Obesity

Energy Balance

Environmental and Genetic Factors

Genetic Syndromes

Gene and Protein Function


8. Behaviors, Addiction, and Eating Disorders

Behaviors and Addiction

Eating Disorders

Unintentional Weight Loss

9. Which “Way” Is the Right “Weigh?”

Measuring Body Fat

10. Physical Assessment of the Adult Obese Patient

11. Physical Assessment of the Pediatric Obese Patient

12. Physical Activity, Exercise Assessment, and Patient Recommendations

History of Physical Activity Recommendations

Key Concepts of Physical Activity

Patient Evaluation

Objective Methods to Assess Physical Activity

Effects of Exercise Response and Training

Exercise Testing

Exercise Programming

Special Considerations

13. Dietary Assessment and Patient Recommendations

Jennifer Roth

Starting With a New Patient

Nutrition Screening

Monitoring Patients’ Eating Patterns and Habits

Daily Food Record or Journal

Estimating Needs for Weight Loss

Diet Composition

Portion Control


Counseling to Improve Behavior Change

14. Psychological Assessment

Case Study 3


15. Disease Management and the Role of the Advanced Practice Nurse

16. Obesity-Related Diseases



Cardiovascular Disease

Diabetes Mellitus

Obesity and the Pulmonary System


Polycystic Ovary Syndrome

Metabolic Syndrome

17. Obesity-Related Diseases: A Pediatric Focus



Diabetes Mellitus

Obstructive Sleep Apnea


18. Prevention

Prevention Guidelines

School Opportunities for Prevention Focus

19. Weight Cycling

Commonalities in Weight Cycling

Health Consequences of Weight Cycling

Case Study 4


20. Treatment of Addiction and Eating Disorders

Food Addiction

Eating Disorders—Anorexia and Bulimia

21. Pharmacological Therapy

Pharmacotherapy for Obesity

FDA-Approved Obesity Medications

Off-Label Drug Use

Nonprescription Medications

FDA-Withdrawn Medications

22. Surgical Therapy

Candidates for Bariatric Surgery

Medical Clearance for Bariatric Surgery

Surgical Procedures

Postoperative Complications

Long-Term Follow-Up

23. Costs Associated With Obesity Treatment and Insurance Coverage

Costs Associated With Obesity

Insurance Coverage

24. Treatment of the Obese Pediatric Patient

Medical Treatment

Pharmacological Therapy

Bariatric Surgery

25. What Is Lifestyle Medicine?

26. Clinic Establishment, Medical Therapy, and a Multidisciplinary Approach

Clinic Establishment

Action Plan

Risk Analysis

Time Frame


Treatment Approach


Primary Care Weight-Loss Counseling

2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults


Case Study 5

Comprehensive Case Study

Recommended Answers to Cases

Weight Management Tools and Resources

Center for Lifestyle Medicine Sample Business Plan


Appendix A: Strengths, Weaknesses, Opportunities, and Threats

Appendix B: Implementation Plan/Theory Outcomes Model

Appendix C: Timeline

Appendix D: Risk Management Matrix

Appendix E: Center for Lifestyle Medicine Patient Letter

Appendix F: Center for Lifestyle Medicine Provider Letter

Appendix G: Center for Lifestyle Medicine Description of Services

Appendix H: Staff Education

Appendix I: Nutrition and Exercise Journal

Appendix J: Baseline Assessment

Appendix K: The Borg Rating of Perceived Exertion (RPE) Scale

Appendix L: Insurance-Based Package

Appendix M: Noninsurance-Based Package Options

Appendix N: Group Fitness Class Prices