Implications for NPs and PAs

Obesity clearly worsens outcomes in COVID-19 and NPs and PAs must be aware of this risk to advise patients accordingly in health promotion. Understanding the implications of diet and socioeconomic risk can improve disease outcomes.

Careful screening of patients for BMI helps modify the risk for negative outcomes of COVID-19. When clinicians make patients aware of their high BMI and the associated risks, they can provide improved access to weight management and obesity reduction strategies. Patients who have a good rapport with their health care providers might be more amenable to adopting diet and lifestyle changes, such as eating healthy, balanced meals that will improve their BMI and reduce comorbid conditions of obesity.

Clinicians can explain to patients how they can incorporate more physical activity into their daily routines. Ask patients what small changes they can make to introduce exercise into their daily schedule. Taking the stairs instead of an elevator or escalator, finding ways to sit down less and move around more, or reducing screen time are some simple suggestions. Instead of merely recommending changes or providing resources for patients to follow up with on their own, NPs and PAs should include patients in the planning process so they feel more ownership of the changes.

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Clinicians can refer patients to health coaches and dietitians or nutritionists to ensure that they follow through on the recommended changes. Practicing NPs and PAs should support all patients with lifestyle modifications for weight management to protect against physiological imbalances that favor inflammation, oxidative stress, endothelial dysfunction, and immune dysregulation. When clinically indicated, patients should be referred for weight-loss pharmacotherapy or bariatric surgery.

Although more studies are needed on this topic, safeguarding patients with obesity in this health risk is pivotal during the COVID-19 pandemic. Accurate information and education are key for patients with obesity to stay safe and healthy, and NPs and PAs play an important role in patient education. When clinicians communicate effectively with their patients and help them implement a plan for modifying unhealthy behaviors and lowering their BMI, they help reduce devastating COVID-19 complications.

Kristene Diggins, DNP, MBA, FAANP, CNE, NEA-BC, DCC, is a doctorate-prepared NP with 15 years of experience as a family NP, in both primary and geriatric care. In addition, Kristene is certified as nurse educator and administrator. She served as the National Manager of Professional Practice for 4 years with Minuteclinic, supporting nurse practitioners in their career development. Kristene works as adjunct faculty for University of Phoenix as well as Chamberlain University and Liberty University. Kristene and her husband live in Charlotte, NC.


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