Weight loss Resources

This article provides an update on the dietary management of type 2 diabetes mellitus (T2DM) for community nurses. Dietary change can greatly modify the trajectory of T2DM. Weight changes are a key factor, as significant weight loss can put the condition into remission, and even less dramatic weight loss can have positive effects on glycaemic control and cardiovascular risk factors in individuals with T2DM. Protein intake supports various aspects of glycaemic management and is an especially important nutrient for older adults, who are more prone to T2DM. Carbohydrate restriction is widely advised in clinical practice, although current guidelines do not support this as the sole dietary management strategy for T2DM; it is simply one of various potentially effective measures. Carbohydrate quality is important and high fibre carbohydrates are the preferred source. Excessive alcohol intake can exacerbate T2DM via its damaging effects on the liver. Knowledge of the dietary management of T2DM is vital for community nurses, as it allows them to offer advanced and comprehensive care to their patients.

The UK has a population of approximately 11 million adults, 18.6% aged 65 and over (Centre for Ageing Better, 2022). Indeed, the demographic profile of the population of England and Wales and primary care records indicate that one in five people are over the age
of 65 in England (Office for National Statistics [ONS], 2018; Robards, 2020). The condition of frailty is more prevalent in the older person, and estimates provided by various studies suggest that 3% of people over the age of 65 in England have the condition (Clegg et al, 2016; Sinclair et al, 2021). Community nurse caseloads are representative of the ageing population of the UK and frailty has been recognised as a clinical condition of the older person (Leary and Bushe, 2022). Early detection of frailty by experienced nurse practitioners can assist in developing a management strategy for the patient in order to inhibit progression of the condition (Ruiz et al, 2020).

Malnutrition continues to be a problem, which is estimated to cost £13 billion per annum (British Association of Parenteral and Enteral Nutrition [BAPEN], 2010). The majority of those at risk of malnutrition are living in the community. When resources are limited, it is important to identify who is most at risk so that they can receive appropriate support. This article explains the malnutrition carousel, where malnutrition leads to poor health that then further increases the risk of malnutrition. It discusses the need for balanced diets to help maintain an adequate nutritional state, highlighting which disease states are likely to cause further problems — in particular, those with swallowing problems where texture-modified diets are required. Suggested solutions are also provided to help treat suspected poor nutritional intake.

A six-week community wellness programme was conducted to promote weight loss and reduce obesity.  Participants’ weight, blood pressure, waist circumference, body mass index, and finger-stick glucose were measured before and after the programme which included exercise, nutrition and diabetes prevention sessions. Initially, 189 men and women enrolled; 74 participants were included in the post-intervention data collection. Statistically significant results (p <0.001) indicated that women reduced weight (mean 3.31% ± 0.02%) and decreased  waist circumference by 1.91552% ± 2.14454 inches. Men reduced weight significantly (mean 6.5% ± 0.44%) and decreased waist circumference (mean 3.14063 ± 3.04118 inches) (p<.001).

Jenny Manry, DNP, FNP, APRN-BC, Assistant Professor, Fort Hays State University
Jane Peterson, PhD, APRN, FAANP, Clinical Associate Professor, University of Missouri Kansas City

Article accepted for publication: February 2013

One of my New Year resolutions was to lose weight by the end of 2015. I’ve also vowed to start formally collecting my portfolio evidence in preparation for my own revalidation later in the year. I’m not entirely sure which of these resolutions it will be easier to stick to... Find out more.

Jeanette Haslam gives an overview of female stress urinary incontinence.
Jeanette Haslam, MPhil, Grad Dip Phys, MCSP, RP is an Independent Clinical Specialist in Women's Health, Senior visiting lecturer, University of Bradford.
Article accepted for publication: October 2005
Illustrations reproduced within this article are by kind permission of the Lilly/Boehringer Ingelheim alliance.