1. Introduction
This case study “Fetal Alcohol Syndrome: A Case with a Multisystemic Presentation” (LaDue and Streissguth, 1992) provides a window to the world of alcoholism and the potential detrimental effects that the consumption of alcohol has on a fetus. This case study discusses a child with Fetal Alcohol Syndrome (FAS) and the multiple effects that alcohol has had on the child’s growth and mental development. At the end of the case study, the authors suggest that the primary prevention of FAS is the control of alcoholism in the childbearing population and that secondary prevention must be the identification of children at risk for FAS, so that they and their families can be helped with confirmed effective intervention programs. FAS is a severe outcome of fetal alcohol exposure and its effects have been documented, demonstrating that prenatal alcohol damage is the cause of major learning and behavior problems which affected children show, which can be related to obesity. Sister Callista Roy’s Adaptation Model (RAM) will be the framework for the analysis of these two case studies. RAM will be used to diagnose the specific problems related to alcoholism and its effects on obesity and the potential effective intervention programs which can help prevent and/or eliminate these problems.
Many individuals are struggling with overcoming the addictions from alcoholism as well as food, and the relation that they have with one another. The National Institute on Alcohol Abuse and Alcoholism defined a standard drink to be a 12-ounce can/bottle of beer, 5 ounces of wine, or a 1.5 ounce shot of distilled spirits. The Substance Abuse and Mental Health Services Administration considers binge drinking to be 4 drinks on any single day. Recent evidence has shown that fat ingestion and alcohol consumption lead to an increase in the probability of becoming overweight and/or obese. Studies have shown that increased alcoholism leads to an increase in obesity, regardless of the type of alcohol and alcohol consumption levels. This occurs because alcohol has almost twice the calories of sugar and high starch foods, but research has shown that pure sugar and starch have lesser calorific effects on fat metabolism than alcohol. Other than the high caloric value of alcohol and mixers, consumption of alcohol triggers a disruption in the body’s energy balance. The body breaks down ethanol in preference to fats, thus reducing fat metabolism. In addition to the reduced fat metabolism, alcohol increases appetite and its stimulating effects lead to increased food consumption.
1.1 Background of the Case Study
Obesity is an excess of body fat. There’s no universally accepted definition of obesity beyond “too much body fat”. Specific statistical measures have been devised to determine an “optimal” or “healthy” amount of body fat, such as body mass index, weight-for-height tables, and skinfold measurements, but no measure has been shown to be better than any other. Obesity is usually defined by the use of these measures and an assessment of associated risk. At some level of body fat, the likelihood of developing certain diseases increases. These diseases have been defined as the “complications” of obesity and are currently part of the definition of this disease. The patient’s body mass index is 34, which is in the range considered obese. His reasons for attempting weight loss at the present time are left unstated.
Obesity and alcoholism are a growing issue in the United States and are now considered chronic diseases. A variety of genetic and environmental factors contribute to the onset and progression of these diseases, which usually begin in childhood and adolescence. Once established, these diseases often persist over time and can be difficult to impossible to reverse. This case study will examine an adult male with obesity and alcoholism. The patient reports a history of attempted weight loss in the past without success. He denies other dietary approaches to decrease his caloric intake. Generally, he primarily drinks beer to the exclusion of other forms of alcohol.
1.2 Purpose of the Analysis
The primary aim of the analysis is to evaluate the two possible courses of action, and in the course of doing so, to address the key issues facing a potential client in this case. The client is the state of Newville. Newville is in the midst of a public health crisis consisting of two separate yet interrelated problems. First, Newville has a binge drinking problem. Studies show that Newville residents drink an excessive amount of alcohol in one sitting more than in any other state. This binge drinking is resulting in many adverse outcomes for the state. Excessive alcohol consumption is the second leading cause of preventable death in the United States. Measures of excessive drinking in the state are higher than the national average. The state ranks 11th in the New County Health Rankings for excessive drinking. High school students and adults in the state drink at higher than the national average levels, and 18% of adults report binge drinking. These rates have put Newville on a path of excessive alcohol consumption for current and future generations, and if left unchecked will result in profound negative consequences for the health and welfare of Newville residents. This trend is to the benefit of the beer and spirits industry, but in economic and human terms, devastating for the state. Excessive alcohol consumption increases the rate of accidents and injuries, and is the cause of many other serious public health problems. In terms of health care expenditure, the medical cost of excessive alcohol is estimated to be about $2 billion annually.
1.3 Scope of the Analysis
This analysis will seek to address a number of issues. The obvious intention is to understand the etiology and treatment of obesity and alcoholism, discussing the many issues it raises for the medical management of these conditions in an outpatient setting. The case has enormous implications for the practice of primary care in general and for the physician’s role as a promoter of mental health and as the leader of a health team. Recommended treatment will involve a referral to social work for family therapy. The event has significant implications for social work in the area of family therapy and raises many questions regarding allocation of care management resources. This analysis also has relevance for public health practice and raises important issues about preventive care (both primary and secondary) in a specific cultural context. A discussion of the efficacy of treatment at all stages should provide some guidance for case management and will likely reveal numerous lessons at the individual and family levels. Some recommendations will be made for policy, particularly in education of physicians and in curriculum at all levels of training for mental health workers.
This paper aims to analyze the case of obesity and alcoholism. The analysis covers four levels. The first level begins with the two patients, their biographies, medical histories, psychological and emotional states, and drives. The second level shifts the focus, looking at the family lives of the two patients, and the third will put the case in the larger context of the societal and cultural issues present in the modern United States. The final level will suggest policy moving the case in a direction necessary for primary and secondary prevention. Due to the complexity and breadth of these cases and the many fundamental issues it raises for family therapy in a public health context, the analysis will not answer all the questions it raises. Rather, its goal is to provide a detailed exploration of specific issues.
2. The Relationship Between Obesity and Alcoholism
2.1 Overview of Obesity and Its Causes
2.2 Overview of Alcoholism and Its Effects
2.3 Common Factors and Interactions
3. Case Study Methodology
3.1 Selection of Case Studies
3.2 Data Collection and Analysis Techniques
3.3 Limitations of the Case Study
4. Case Study Findings
4.1 Case Study 1: Obesity and Alcoholism in Adults
4.1.1 Factors Contributing to Obesity and Alcoholism
4.1.2 Health Consequences and Risks
4.1.3 Treatment and Intervention Strategies
4.2 Case Study 2: Obesity and Alcoholism in Adolescents
4.2.1 Influencing Factors during Adolescence
4.2.2 Impact on Physical and Mental Health
4.2.3 Prevention and Intervention Approaches
5. Comparative Analysis of Case Studies
5.1 Similarities and Differences in Findings
5.2 Patterns and Trends Identified
5.3 Implications for Public Health Policies
6. Conclusion
6.1 Summary of Key Findings
6.2 Recommendations for Future Research
6.3 Implications for Clinical Practice
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