Answer to Question 1
Risks with untreated morbid obesity include:
Type 2 diabetes: 3 as prevalent among obese persons compared to those with normal weight
Hypertension (high blood pressure): 3 more common in the obese
Dyslipidemia (abnormal lipid profile, high cholesterol, low HDL, high LDL, high triglycerides)
Gallstones: 6 greater risk for gallstones among persons who are obese
Non-alcoholic fatty liver disease: central adiposity is a risk factor for NAFLD
Cancer:
Men are at an increased risk for esophageal, colon, rectum, pancreatic, liver, and prostate cancers
Women are at an increased risk for gallbladder, bile duct, breast, endometrial, cervix, and ovarian cancers.
Coronary heart disease
Myocardial infarctions (heart attacks)
Angina (chest pain)
Sudden cardiac death
Sleep apnea (inability to breathe while sleeping or lying down)
Asthma
Reproductive disorders:
Men: gynecomastia (enlarged mammary glands in males), hypgonadism, reduced testosterone levels, and elevated estrogen levels
Women: menstrual abnormalities, polycystic ovarian syndrome
Metabolic syndrome
Premature death: obese individuals have a 50-100 increased risk of premature death compared to healthy-weight individuals.
Bone health: obesity can increase chances of osteoporosis or decreased bone mineral density
Health risks Mr. McKinley presents with:
Osteoarthritis
Type 2 diabetes
Hyperlipidemia
Hypertension
Metabolic Syndrome (TG 150 mg/dL, HDL < 40 mg/dL, BP 130/85 mmHg; also highly likely that his FPG 100 mg/dL due to DM dx)
Mr. McKinley has been obese his whole life, which puts him at an increased risk for type 2 diabetes, hyperlipidemia, hypertension, and osteoarthritis.
Answer to Question 2
BMI = 33.3 using current body weight at admit (170 lbs)
BMI over 30 is considered obesity, but Mrs. J has gained 20 lbs in the last 2 weeks, which is mostly water
One may consider calculating her BMI based upon her dry or nonedematous weight:
- BMI = (77.3 kg - 4 kg) / (1.524 m)2 = 31.5 (still obese)