Management of Obesity Among the Older Adults | Nursing

Running head: NURSING
Nursing
Name of the Student
Name of University
Author’s note

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Introduction
The following assignment is based on the story of Fredric Arum, a 78-year old obese
man. The paper will aim to elucidate the evidence-based intervention for the management of
obesity among the older adults. In doing so, a review of four papers will be conducted in this
assignment based on the principal theme of over-weight and weight loss. Review will highlight
the strength and weakness of the methodological framework adopted in each of the followed by
the critical analysis of the interventions proposed and whether or not it will be effective for the
older adult mentioned in the selected case study. The assignment as a whole aims to focus on the
concept of healthy aging and its importance for comprehensive health and well-being.
Authorship of the paper
The authors of all the four selected research articles have the required expertise and
affiliations for the conduction for research. According to Harnad (2017), one of the important
criteria behind the selection of papers to generate evidence based practice is to selected papers of
the authors from the esteemed academic or science institutions. This helps to increase the overall
research rigour and credibility of the review from which evidence-based practice (EVB) will be
generated.
Research questions and Methodology
Batis et al. (2016) aim was to select an appropriate intervention for the effective
management of obesity among the older adults. In order to achieve their name, Batis et al. (2019)
conducted a systematic review of randomised control trials (RCTs). According to Murad et al.
(2016), according to the hierarchy of evidences based on the methodological quality of the

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research, systematic review of RCTs secure the first position (level 1) such that, Batis et al.
(2016) scores top in hierarchy of evidences. The authors here selected papers where the average
age of the target population if 65 years with mean body mass index (BMI) is 30 Kg/m2. The
review of RCTs showed that behavioural weight loss interventions with pharmacological and
procedural change lasting for one than 6-month is helpful for fighting against obesity but only at
low to moderate level. The authors recommended more well-designed trial for the generation of
EBP in this particular topic. The review was conducted based on the papers that were published
within 2005 to 2016. The selection of the papers that are published within the last 10 years can
be regarded as one of the strength of the study to separate researchers were appointed to conduct
the methodological review of the selected study and this helps to avoid the chances of selection
bias and observational bias. The second selected article of the theme aims towards analysing the
evidence associated with age-related change in the fat composition of the body and its relation to
the basal metabolic rate, vicious cycle and simultaneous development of age related
complications (Jura & Kozak, 2016). The final review results reported that age related changes
associated with the body fat composition increases the vicious cycle and thereby accelerating the
overall process of aging. Though the review was informative, there was no specific
methodological framework used in the review for the process of the selection of the journal
articles. The study was based on inductive approach which signifies that the hypothesis of the
study was coined before its initiation and thus increasing the chances of getting researcher or
observational bias. Locher et al. (2016), the aim were to analyse the role of calorie restricted diet
in promoting weight loss among the older adults. The result showed that calorie restricted diet
helps in promoting a significant weight loss among the target group of geriatric population. One
of the principal strengths of the study is the review was based on the RCTs paper however the

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sample size of the study was inadequate as the author selected only 7 RCT studies for the
conduction of the review. The systematic reviews which are based on the sample size lower than
10 are assumed to be bias as the reported results are not suitable for global or mass application.
The study of Waters, Ward and Villareal (2013) aimed towards addressing whether the weight
loss among the older adults is achievable under a co-ordinated and safe process. The authors
selected only the primary research papers for the conduction of the systematic review. Finally the
review was conducted over 10 selected articles. The selection of diverse primary studies like
RCTs helped to increase the level of evidence of the paper and this can be regarded as one of the
strengths of the study. The study also used theme based analysis in order to evaluate the final
conclusion and thereby helping to get a stringent representation of the data. The final result of
the study however failed to conclude any significant evidence in favour of save weight loss
intervention among older adults and the authors proposed for further research trials in order to
generate evidence-based practice.
Key themes of the research
All the four articles that were selected for the review under the theme of overweight and
weight-loss failed to provide any significant conclusion. All the studies recommended for the
conduction of the further research trial in order to establish evidence based practice for obesity
management among the older adults. However one theme that can be generated from the case
study includes: diet and exercise for the promotion of healthy aging and weight loss.
The review conducted by Batsis et al. (2017) highlight it that the consumption of healthy
diet along with regular practice of mild-to-moderate physical activity helps in improving the
overall physical performance of older adults and thereby helping to promote healthy quality of

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life. This lifestyle intervention also help in reducing the chances of losing muscle mass and lean
body fat and thereby helping to accelerate the process of aging. Jura and Kozak (2016) similarly
highlighted that the practice of physical exercise among older adults might lead to the loss of
lean body mass and thereby promoting excessive weight loss. However the loss in the lean body
mass reduces mineralization in the bones and thereby reducing the bone density and increasing
the vulnerability of the development of osteoporosis and sarcopenia. Consumption of healthy
protein diet along with mild to moderate physical activity is recommended for reducing the BMI
of the body. The protein rich diet will help to regain the muscle mass and thus, preventing the
vulnerability of developing sarcopenia. RCT based systematic review conducted by Locher et al.
(2016) highlighted similar evidences like Jura and Kozak (2016). It stated that consumption of
calories restricted diet along with conduction of physical activity helps to reduce the body mass
among the older adults and thus helping to fight against obesity. The review results of Waters,
Wards and Villareal (2013) highlighted that change in the body fat composition along with
change in pattern of the dietary intake and practice of physical activity can be sustained for long
time and helping to improve the lifestyle intervention. All the assimilated results of the study
stated their hypothesis in favour of the healthy lifestyle interventions like use of one or more
non-pharmacological intervention for the healthy regulation of body weight.
Agreement and Disagreement of the literature
Taking into reference of the case study, it can be stated that losing weight will help
Fredric Arum to reduce the strain over his joints and this helping to reduce the joint pain.
According to Jura and Kozak (2016) obesity promotes the ageing process by prompting decaying
of the bones. By reducing weight, the health of the skeletal muscles can be restored and thereby
decreasing the exponential rate of the aging process and helping to improve the quality of life.

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Weight training interventions as proposed in the case study will not be suitable for Fredric Arum
as it will further increase strain over joints along with cardiac muscles. Fredric Arum is keen in
reducing weigh but is not willing do exercise as he is scared in that scenario controlled dietary
intake can be an option followed by regular conduction of mild to moderate physical activity like
gardening will help to reduce the BMI (Backx et al., 2016). Fredric Arum loves to do gardening
and thus he will provide spontaneous consent for the same and in case of dietary regulation,
cyclic diet will be helpful in re-energizing his taste buds while killing the monotony (Backx et
al., 2016).
Conclusion
Thus from the above discussion it can be concluded that all the four selected papers under
the theme of over-weight and weight loss failed to highlight any specific EBP for geriatric
weight loss. The review however, helped in understanding the importance of healthy lifestyle
interventions for promoting the concept of healthy aging and reducing the chances of exponential
aging. Weight training or rigorous physical exercise is not recommended for the older adults at
this will increase strain over muscles however, BMI must also be reduced. So the optimal
intervention includes high protein diet and regular practice of mild to moderate physical activity.
However, further research must be undertaken in order to establish the EBP guidelines.

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References
Backx, E. M. P., Tieland, M., Borgonjen-van Den Berg, K. J., Claessen, P. R., Van Loon, L. J.
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