This issue is devoted to the impact and effects of obesity on the musculoskeletal system. Obesity in America is a frequent topic in the media. Discussions about new diet fads, weight loss programs that have been around for years, surgical options for weight control, ready-made portion-controlled meals delivered to your home or office, and various pharmaceutical products can be found in magazines, on television, and on the Web. The concern over health issues related to excessive weight is not new. Hypertension, diabetes, and heart disease have long been known to be sequelae of obesity, and what happens to the bones and joints of the obese is also a concern.
Childhood obesity is increasing in frequency. Many different theories exist as to why this is occurring, including lack of activity, increased use of computer games, and the prevalence of fast foods in the diets of children of working parents. In "Looking at Childhood Obesity Through the Lens of Baumrind's Parenting Typologies" (p. 270), Luther offers fascinating information about how parenting affects the health outcomes of children. Palmer (p. 293) discusses the need for metabolic screening to help identify those children who are at risk for the development of obesity.
Pearson-Ceol's literature review (p. 289) on the effects of obesity on the knee joint reveals the increase of osteoarthritis in the knees of obese patients and believes that future nursing research is indicated for improving this problem. Looking at the problem of how obesity is related to the health of the hip (Gelber, 2003) and to the spine (Fanuele, Abdu, Hanscom, & Weinstein, 2002) also reveals that increased weight impacts and affects other areas of the body.
The management of obesity is not an easy undertaking for either the patient or the practitioner. Various methods for managing weight loss exist as mentioned above. Thus, selecting the right treatment path after evaluation of the risks and benefits of each option is of great importance.
Berarducci (p. 281) discusses the problem of bone loss in patients who have undergone bariatric surgical procedures. Exchanging the problem of obesity for bone loss must be considered when making a treatment decision. At the very least, early intervention to help mitigate bone loss is indicated.
Nurses are positioned to be key members of healthcare teams helping to manage the problem of obesity. Recognition of the problem, providing education, resources, and support for the patient to be successful in a weight loss program are essential. Bone health is impacted by excessive weight and should be the impetus in the identification of a program that best meets the individual patient's needs.
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