1-Mr. C has a variety of health issues related to his obesity. He has an elevated fasting blood glucose which indicate that he could be diabetic, an A1C level should be drawn to follow up with that. He also has elevated triglycerides, normal levels for a male should be between 40-170, his is 312. His total cholesterol are elevated as well, which normal levels should be less than 200, and his is 250 (Comprehensive Guide to Normal Lab Values, 2019).  Keeping that in mind, he probably has high cholesterol diagnosis as well. His blood pressure is also elevated, which means that he needs more than just sodium restriction in his diet to control. Without him being on any medication, he is asking for a stroke in my opinion. Further education needs to be provided for him especially in needing to change his diet. Not only does he need to control his sodium intake, he also needs to monitor, carbs and sweets.  Personally, I would not recommend bariatric surgery until I am convinced that he is ready for the change. I would recommend that he loses some weight first since it would be risky with him being obese, to even undergo anesthesia.  Health      perception- Mr. C has a poor general health as evidenced by his lab levels      and vitals. It seems that with his sedentary lifestyle, he is lacking      exercise which would be very beneficial for him at this point. He is      realizing that he needs help with his obesity and is considering bariatric      surgery, so that is a positive.  Nutritional-Metobolic Pattern- It seems that with his high BMI, high HDL and cholesterol levels, he has a poor eating habits. He did mention that he attempts to control his blood pressure with sodium restriction.  Elimination- This category was not discussed.  Activity-Exercise Pattern- He works at a catalog telephone center, which means that he probably does not get much exercise with this job. He lives a sedentary lifestyle.  Sleep-Rest Pattern- He mentioned that he has sleep apnea.  Cognitive-Perceptual Pattern- He did not mention any cognitive deficits or hearing difficulties. He works at a telephone center so he must have good communication skills.  Self perception- He did not mention much of his life outside of his job, so he may have low self-esteem associated with the obesity.  Sexuality reproductive pattern- This was not discussed.  Coping stress tolerance pattern- This was not discussed but he is seeking help with his obesity.  Values Beliefs pattern- This was not discussed.  5      problems- His sedentary lifestyle is a problem that needs to be addressed.      Mentioning that including even walking on his lunch break could make a      huge difference in losing weight. Him not being able to control his blood      pressure with just restricting sodium from his diet alone. With this high      of blood pressure and high cholesterol he is a major risk for a stroke, as      I mentioned above. Getting him started on medication would be crucial for      him ...

1. 1-Mr. C has a variety of health issues related to his obesity. He
has an elevated fasting blood glucose which indicate that he
could be diabetic, an A1C level should be drawn to follow up
with that. He also has elevated triglycerides, normal levels for a
male should be between 40-170, his is 312. His total cholesterol
are elevated as well, which normal levels should be less than
200, and his is 250 (Comprehensive Guide to Normal Lab
Values, 2019). Keeping that in mind, he probably has high
cholesterol diagnosis as well. His blood pressure is also
elevated, which means that he needs more than just sodium
restriction in his diet to control. Without him being on any
medication, he is asking for a stroke in my opinion. Further
education needs to be provided for him especially in needing to
change his diet. Not only does he need to control his sodium
intake, he also needs to monitor, carbs and sweets.
Personally, I would not recommend bariatric surgery until I am
convinced that he is ready for the change. I would recommend
that he loses some weight first since it would be risky with him
being obese, to even undergo anesthesia.
Health perception- Mr. C has a poor general health as
evidenced by his lab levels and vitals. It seems that with his
sedentary lifestyle, he is lacking exercise which would be
very beneficial for him at this point. He is realizing that he
needs help with his obesity and is considering bariatric
surgery, so that is a positive.
Nutritional-Metobolic Pattern- It seems that with his high BMI,
high HDL and cholesterol levels, he has a poor eating habits. He
did mention that he attempts to control his blood pressure with

2. sodium restriction.
Elimination- This category was not discussed.
Activity-Exercise Pattern- He works at a catalog telephone
center, which means that he probably does not get much
exercise with this job. He lives a sedentary lifestyle.
Sleep-Rest Pattern- He mentioned that he has sleep apnea.
Cognitive-Perceptual Pattern- He did not mention any cognitive
deficits or hearing difficulties. He works at a telephone center
so he must have good communication skills.
Self perception- He did not mention much of his life outside of
his job, so he may have low self-esteem associated with the
obesity.
Sexuality reproductive pattern- This was not discussed.
Coping stress tolerance pattern- This was not discussed but he
is seeking help with his obesity.
Values Beliefs pattern- This was not discussed.
5 problems- His sedentary lifestyle is a problem that needs
to be addressed. Mentioning that including even walking on
his lunch break could make a huge difference in losing
weight. Him not being able to control his blood pressure
with just restricting sodium from his diet alone. With this high
of blood pressure and high cholesterol he is a major risk for
a stroke, as I mentioned above. Getting him started on
medication would be crucial for him. I would also address
that sleep apnea a little further as well. Asking if he is using
a CPAP machine at home and how deligiant he is at using it.

3. Another problem, is his diet. I would have him be referred to a
nutritionist or further educate him on learning to maintain
his diet. I would recommend weight watchers, they have a
great program that is easy to manage with just an app. They
even have support groups as well so he can meet people
through it. If he does not control his diet and continue
gaining weight, he would be at risk for many other diseases
that cause a shorter life and could be life threatening.
Reference
Comprehensive Guide to Normal Lab Values. (2019). Meditec.
Retrieved from
https://www.meditec.com/resourcestools/medical-reference-
links/normal-lab-values/
2-I agree that these days people look for a quick pill to take
care of their problems. There are so many fad diets and they are
just not realistic in helping people to maintain a healthy
lifestyle. A family friend once did an all shake diet and of
course lost several pounds because of the lack of caloric intake.
He maintained the weight loss for less than a year before
quickly regaining it plus some. Changing lifestyle behaviors and
educating yourself on the importance of a well-balanced diet is
extremely important for making positive and long-term changes
for yourself. I think the same would go for Mr. C. He needs to
know how to continue to strive for a healthy lifestyle after the
surgery in order to maintain his weight after.
Reply | Quote & Reply

4. 3-it can be tough to face things like obesity and hypertension,
especially at such a young age. It is good that she has you and
your family for support. It is also good that she is identifying
that she has issues that need to be addressed and taking the
steps to make better choices. Weight watchers can help to teach
individuals about healthy nutrition and portion control. Walking
her dog everyday is also a good step towards getting more steps
in and living a healthier lifestyle. It can be hard I'm sure to sit
behind a desk all day and then come home and find the energy
to exercise. Keep on encouraging her!
4-Yes the follow through of diet is so important. When my
sister had the surgery several years ago she had to lose about
50# prior to the actual surgery. Part of that process was to
shrink the stomach and get used to smaller meals. One of the
complications after the surgery can be"dumping syndrome".
This is when a rapid emptying of the stomach occurs and moves
into the small intestine. Many people experience this and can
have symptoms of bloat, diarrhea, dizziness, nausea and
sweating (Rovito, 2019). Ways to prevent this is to have no
refined sugar or unnecessary fat, eat 5-6 smaller meals and no
liquids between meals (Rovito, 2019). I read that doctors
actually don't mind when thsi occurs in patients because it helps
them to try and to eat better. I know for my sister she had to
really learn how to eat..she intiially lost an incredible amount of
weight and looked quite unhealthy but then it stabilized. She
started to gain her weight back but the physician put her on
some medication to reduce her appetite and that helped and she
lost more weight. She goes to a physician every 6 months and
this has helped to keep her on track. She eats very little because

5. she gets so full but she doesn't mind..her brain has learned to be
okay with smaller amounts.
Reference
Rovito, P. (2019, February 4).
Complications of gastric bypass surgery 22 potential problems.
Retrieved from https://www.bariatricsurgerysource.com
5- Weight loss has to do with burning more calories than you
take in. You could theoretically eat junk food that totals 1200
calories a day and loose weight. The problem comes in when
you are hungry shortly after eating that junk food. The trick is
to eat foods that help you feel full for a longer amount of time
and use portion control. I would rather eat foods that keep me
from feeling hungry. With bariatric surgery, your stomach is
shrunk down so you should only ingest teaspoons of broth at a
time. If you have psychological need to eat foods, you will
stretch your stomach out again and regain all the weight you
lost. Eating for most people in this country is not a survival
thing....it is an emotional thing. You tie your emotions to food.
People in Africa or India do not have the luxury of eating due
to stress. Until you recognize food as fuel, you will not likely
keep off the weight you lost.
I think it is important to teach our children a different way of
looking at food. It should be gas for your body and we should
be putting in unleaded. We should teach them to not overfill
the tank; stop associating food with love or other emotions.

6. 6- I would say most of the people in this class already
understand the difference between type 1 and type 2 diabetes.
Type 1 being an autoimmune disease that attacks individuals
who are genetic carriers of HLA type genes. Type 2 has a
genetic component however, it is an acquired disorder that
becomes active due to obesity and lack of exercise causing
insulin resistance.
There is a very long and detailed explanation regarding your
question about obesity and type 1 diabetes. In the past, type 1
diabetes was only diagnosed in childhood and these children
were diagnosed after a significant weight loss. Children in
general were already thin, active and healthy eaters because this
was the lifestyle. In recent times, the increase in technology
and junk food has caused a rise in obesity in all populations but
especially children. Type 1 diabetics do not escape this trend.
One article even says that there is a higher incidence of obesity
in type 1 diabetics than any other people group (Mottalib et al.,
2017). This article goes further into detail about insulin and the
growth hormone along with how they affect the basal metabolic
rate. You can read the details for yourself, but to sum it up,
type 1 diabetes does not make your body immune to fat
accumulation anymore than anyone else. If you left type 1
diabetes untreated with insulin for a long period of time, you
would have weight loss from cell starvation. Of course, you
would go into significant keto acidosis and could die.
Treating the type 1 diabetes with insulin reverses the effects
of weight loss. In fact, hyperinsulinemia causes obesity and
increases the growth hormone. This is seen particularly in
mothers with gestational diabetes. The mother has increased
glucose levels that increases her need for insulin. Her body

7. cannot meet the demand, but the fetus has no problem with
insulin production. Glucose crosses the placenta, but insulin
does not. The baby produces the correct amounts of insulin to
cover the increased glucose that crossed the placenta. This
hyperinsulinemia causes the baby to grow to an alarming size.
This causes macrosomia.; a baby that is too large for the
gestational age. As a side note, this increases the baby’s risk of
developing type 2 diabetes later in life.
A trend that has been seen in recent years is to have double
diabetes. Now that we are able to do extensive diagnostic
testing, we can see that a patient could have the antibodies
present with type 1 diabetes and the insulin resistance seen with
type 2 diabetes. Incidentally, obesity in a person with the
antibodies that are seen with the type 1 diabetes causes that
person to become an actual diabetic sooner. I would think in
layman’s terms it is from placing undue stress on the pancreas
to produce higher levels of insulin and the islet cells run out of
juice.
I could go on, but I am guessing this answers your question.
References
Mottalib, A., Kasetty, M., Mar, J. Y., Elseaidy, T., Ashrafadeh,
S., & Hamdy, O. (2017, August 23). Weight management in
patients with type 1 diabetes and obesity.
Current Diabetes Reports
,
17
(10). https://doi.org/10.1007/s11892-017-0918-8