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Obesity/Bariatric Physiotherapy

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Obesity is a strong predictor of adult morbidity and mortality. Any loss of weight is beneficial in reducing many of the complications of obesity. The World Health Organisation guidance for the management of obesity recommends that initial management comprises of a variety of interventions to modify diet and physical activity behaviours. Physical activity is important for maintaining long-term weight loss and managing co-morbidities. The prevalence of obesity in GCC adults has been reported to be 24% amongst males and 40% amongst females. Further, there have been increases in the prevalence of overweight and obesity in GCC states in recent times. More specific to the UAE, one survey, conducted over 15 years ago (1999–2000) found that a third of the population was obese and over 40% overweight.

How can Physiotherapy help Obesity?

Nightingale Physiotherapists can work in the prevention and management of obesity. Obesity leads to restrictions in movement, affecting engagement in physical activity. Along with a holistic, patient-centred, and problem solving approach, Nightingale Physiotherapists have advanced knowledge and skills in:

  • Anatomical, physiological, and psychosocial mechanisms of health and disease
  • Assessment and diagnosis
  • Behaviour change
  • Biomechanics
  • Exercise prescription and therapeutic exercise
  • Management of long-term conditions

While the importance of being physically active is well recognised, in reality patients often experience difficulties in doing so. Nightingale Physiotherapy recognise it is important to facilitate patients to increase physical activity at the right level. An assessment and treatment plan from a physiotherapist will help overcome the barriers to exercise. A treatment plan for an obese patient may comprise of:

  • Provision of personalised lifestyle advice, taking into account individual attitudes, beliefs, circumstances, cultural and social preferences, and readiness to change
  • Prescription, supervision, and progression of appropriate physical activity to increase muscle strength, flexibility, and endurance, and sustain energy output to enhance and maintain weight loss under safe and controlled conditions
  • Management of associated conditions such as arthritis, back pain, and other musculoskeletal and chronic conditions, such as heart disease
  • Co-ordination of comprehensive and sustainable programmes of management in collaboration with service users, other health and social care professionals, and community services.

 

Obesity in Children

Obese children, like adults, often present with a number of musculoskeletal signs and symptoms that may limit their time spent in physical activity. Being obese is detrimental to gross motor skill performance, for example in upper and lower limb coordination, balance, running speed and agility, and strength. These differences become more pronounced as children get older, suggesting the need for early focus on motor skill development to encourage overweight and obese children to be physically active. Physiotherapy-led exercise classes are effective in significantly improving motor skills, activity levels, BMI, and other anthropometry in children.

 

Bariatric Surgery

Common Bariatric Surgeries are Gastric Band, Gastric Sleeve and Gastric Bypass.There is mounting evidence to demonstrate that physical activity can improve weight loss and other outcomes following bariatric surgery. It is consistently seen as the most important predictor of long-term weight loss maintenance. Most preoperative patients are insufficiently active, and without support, fail to make substantial increases in their physical activity postoperatively. Nightingale Physiotherapy can help with the social, physical, and mental barriers preventing physically activity that often happen post surgery to increase physical activity. In particular, patients with pain, balance, gait or other physical or sensory deficits would benefit from physiotherapy.

Evidence-based treatment includes:

  • Assessment of the individual’s medical history
  • Evaluation of current physical activity level
  • Provision of an individualised physical activity program
  • Gradual progression of a physical activity program
  • Prescription of a cardiovascular training program
  • Prescription of resistance exercises
  • Prescription of moderate-intensity physical activity, 30 min per day, 3–5 days per week
  • Calculation of body mass index.

To arrange an appointment with our Obesity/Bariatric Physiotherapist call 800 UAE (823).