Obesity Associated with Hypothyroidism

Epidemiological Data of the Disease

A. Adriana (2013) provides convincing evidence that obesity caused by hypothyroidism has reached epidemic proportions among developing and developed European countries. According to the estimations of the researcher, hypothyroidism causes significant changes in energy expenditure, body temperature, and, finally, composition and weight of a human body, therefore, it results in considerable weight gain among male and female individuals who are diagnosed with this disorder (Adriana, 2013).

Statistics prove that approximately 12.4% of children who suffer from hypothyroidism are classified as obese (Laurberg et al., 2012). On the contrary, the percentage of obese adults with the same type of disease is equal to 50-55% on the territory of Europe. In addition, according to several recent cohort studies, which assess body weight in male and female patients with hypothyroidism, long-lasting thyroid dysfunctions lead to the development and progression of severe hypothyroidism (Laurberg et al., 2012).

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The researchers, who investigate excessive body weight in patients with hypothyroidism, assure that individuals with this disease suffer from excessive weight because the symptoms of severe hypothyroidism result in quick accumulation of water in the skin of a human body and many other related issues of water-binding glycosaminoglycans, which is considered to be the main factor that contributes to weight gain among hypothyroid patients (Laurberg et al., 2012).

Taking into account the results of research experiments, based on the excessive weight of above 200 patients diagnosed with hypothyroidism, the average gain of weight in untreated people constituted approximately 4-4.6 kg, and this weight gain was caused by the excessive amount of water inside a human body (Laurberg et al., 2012). In Italy, more than 21.2% of children diagnosed with thyroid dysfunctions, including hypothyroidism, are classified as overweight. Moreover, more than 80% of thyroid children become obese adults in case this disease is left untreated (Longhi & Radetti, 2013).

A closer look at the data provided by the Canadian Task Force on Preventive Health Care provides evidence that approximately 20% of male patients with hypothyroidism who were screened for obesity are overweight (Farasat, Mughal, & Farooq, 2011). On the contrary, the number of obese women with hypothyroidism exceeds 30-35%. Moreover, researchers have found that sedentary lifestyle contributes to obesity among men and women diagnosed with hypothyroidism because increased consumption of calories, inactive lifestyle, and poor physical activities promote the development of thyroid diseases, especially hypothyroidism that accounts for almost 90% of thyroid dysfunctions (Farasat et al., 2011).

Taking into consideration the information provided by the American Association of Clinical Endocrinologists, the prevalence of obesity on the territory of the United States has drastically increased from less than 15% in 1995 to approximately 28% in 2010 (Ghergherehchi & Hazhir, 2015). Because pathophysiology of obesity is an extremely complex, ambiguous, and imperfectly understood the topic that is influenced by a variety of genetic, environmental, psychological, and, finally, behavioral factors, numerous researchers in the United States focus on the investigation of hormonal changes that lead to obesity in patients of different age groups.

In addition, available data suggests that obesity caused by hypothyroidism promotes the development of many other diseases, including hypertension, infertility, severe neuromuscular dysfunction, stroke, diabetes, and, finally, coronary heart disease among many others (Ghergherehchi & Hazhir, 2015). One of the recent statistical analyses performed by the U.S. researchers provides evidence that approximately 11.4% of patients with hypothyroidism are people with morbid obesity (Ghergherehchi & Hazhir, 2015).

In addition, related evidence suggests that numerous interdependent factors, especially smoking habits, age, social status, sex, age groups, and environment influence the prevalence and degree of obesity in patients with hypothyroidism. Multiple studies that investigate the link between obesity and hypothyroidism in Latin America prove that pregnant women and elderly women are two main vulnerable populations who suffer from the increased risks to become obese because of hypothyroidism (Ghergherehchi & Hazhir, 2015). In the United States, the prevalence of obesity caused by hypothyroidism among female individuals after 35 has increased from 4.5% in 2005 to more than 9% in 2013 (Ghergherehchi & Hazhir, 2015).

Therefore, Farasat et al. (2011) investigate obesity promoted by hypothyroidism and prove that Mexican Americans and whites aged 12 and more are at increased risks to suffer from these health problems, compared to other races and ethnicities in the United States, including black people. According to one of the recent research studies published in the Journal of the American Medical Association, African Americans in the United States are at an increased risk to suffer from obesity than whites. The latest data derived from one of the recent National Health and Nutrition Examination surveys indicate that about one in twenty females with hypothyroidism has excessive weight (Farasat et al., 2011).

According to the data provided by the Thyroid & Endocrine Center of Florida, the prevalence of obesity caused by hypothyroidism among adolescents has increased from 9% in 2009 to more approximately 13% in 2011 (Ghergherehchi & Hazhir, 2015). Data from more than 400 subjects database that explores and assesses the prevalence of obesity promoted by hypothyroidism provides convincing evidence that obesity caused by this endocrine disease results in the development and progression of many related diseases, including cardiovascular diseases, that drastically increase the percentage of early mortality among young male and female individuals (Ghergherehchi & Hazhir, 2015).

Thus, it is possible to come to conclusions that hypothyroidism is closely associated with obesity, and, nowadays, represents a fundamental challenge in different corners of the globe, including Europe and the United States. Many researchers conclude that despite female individuals after 35 are classified as “vulnerable” populations who are at the increased risks to suffer from excessive weight caused by hypothyroidism, the weight gain is usually greater in those individuals who are diagnosed with the more severe form of hypothyroidism.

Nursing Theories and Obesity in Patients with Hypothyroidism

The majority of nursing theories play a critical role in promoting the quality of public health. Therefore, many researchers in the field of healthcare provide convincing evidence that nursing theories play a fundamental role in the effective and timely management of chronic and long-term diseases.

Alligood (2014) explores the importance of nursing theories for the management of chronic diseases and claims that Dorothea Orem’s Self-Care Theory is one of the most effective and extensively used for the management of obesity in patients with hypothyroidism. It is critically important to stress that this nursing theory promotes the idea that every person should bear the responsibility for personal care. Moreover, the author of this theory is a proponent of the idea that every person should possess knowledge of different health problems and possible complications caused by the disease since effective self-care positively influences patients’ lives with a chronic disease (Alligood, 2014).

Since once diagnosed with hypothyroidism, a person is forced to rely on anti-thyroid medications for the rest of life. Dorothea Orem’s Self-Care Theory focuses on effective self-care or, in other words, a set of numerous activities that an obese patient with hypothyroidism should initiate and follow on own behalf in maintaining not only physical but also emotional health and well-being because one of the most common symptoms of hypothyroidism is depression (Alligood, 2014).

According to the detailed health promotion research, the value of The Theory of Nursing as Caring developed by Boykin and Schoenhofer is enormous because this grand nursing theory protects the viewpoint that people should develop the full potential of expressing caring because it is a vitally important life-long process that positively influences the quality of life of people who suffer from numerous diseases (Alligood & Tomey, 2011).

Thus, the Theory of Nursing as Caring should be followed by obese patients with hypothyroidism with the primary purpose of this theory is to achieve overall health. In addition, this general theory may be extensively applied in collaboration with many other professional nursing theories in order to motivate patients with endocrine disorders, including hypothyroidism, to understand that caring will motivate patients with hypothyroidism and obesity to change their eating habits, rely on healthy nutrition changes, and exercise regularly in order to overcome thyroid dysfunction (Alligood & Tomey, 2011).

Peterson and Zderad’s Humanistic Theory may be extensively used by health care professionals for effective management, treatment, and prevention of obesity in patients with hypothyroidism. Indeed, nurses should extensively utilize their theory in order to provide assistance to hypothyroid patients with excessive weight by educating and providing more information about the nature of their disease, possible complications and impacts on other body systems, the significance of pharmacological treatment, and, finally, alternative preventive methods, including a well-developed diet, regular physical activities, and many other methods (Alligood & Tomey, 2011). According to the main ideas promoted by this complex, multidimensional, and, finally, interactive nursing theory, healthy patient-nurse relationships will increase a chance to receive the highest quality of treatment (Alligood & Tomey, 2011).

In order to promote their practice, nurses should incorporate Orlando’s theory in their daily practice for the treatment of patients with long-term disorders, including obesity promoted by hypothyroidism. According to the essence and nature of this theory, the core responsibility of nurses is to be responsive to patients who face a sense of helplessness or depression (Alligood & Tomey, 2011).

This nursing theory may be widely used for providing effective assistance to obese patients with hypothyroidism because it is aimed at avoiding the progression of the disease, eliminating the development of life-threatening complications, relieving physical and psychological signs and symptoms of the disease, and motivating patients to rely on self-care in order to improve their health conditions (Alligood & Tomey, 2011). In addition, the authors of this theory emphasize that the primary responsibility of nurses is directly related to focusing their actions on the provision of effective direct and indirect care that meets the needs of patients (Alligood, 2014).

As a result, after having identified, described, and evaluated the most significant nursing theories which may be applied to management and treatment of obesity in patients diagnosed with hypothyroidism, it is possible to summarize those nursing theories are critically important for nursing practice because they promote the idea that caring is the most fundamental factor that influences and shapes physical and psychological health and well-being of patients with different long-term diseases, including obesity in persons diagnosed with hypothyroidism.

Diagnostics: Positive Diagnosis of the Disease

Accurate diagnosis of hypothyroidism and obesity caused by this pathology is a particularly challenging task because there are many other factors, except hypothyroidism, which stimulate weight gain and increased appetite. In addition, there are many forms of hypothyroidism that increase the difficulty to set a clear diagnosis and develop effective management and treatment strategies. The researchers Jonklaas et al. (2014) who explore the significance of the early diagnosis and development of effective treatment strategies claim that it is critically important to have hypothyroidism diagnosed as soon as possible because it leads to a variety of serious complications, including infertility and heart attack (Jonklaas et al., 2014).

The researchers state that hypothyroidism and obesity promoted by this disease should be diagnosed on the basic of symptoms experienced by patients, thorough examinations, and, finally, effective communication with clients. However, clinical manifestations of the disease should be validated with the help of screening and diagnostic tests (Jonklaas et al., 2014). Buyukgebiz (2013) claims that screening for thyroid disease is of utmost importance because this procedure ensures a chance to set a positive diagnosis of the disease (Buyukgebiz, 2013).

Screening is considered to be one of the most fundamental achievements in the sphere of preventive medicine that ensures a chance to avoid the development and progression of this disease and possible obesity caused by hypothyroidism. Screening should be used by asymptomatic individuals and patients who usually experience mild and nonspecific symptoms (Buyukgebiz, 2013). According to the results of numerous population-based studies of screening, the goal of screening for thyroid dysfunction, including hypothyroidism, is to identify and provide effective treatment to individuals at high risk for numerous health consequences before signs and symptoms of this disease become clinically apparent (Buyukgebiz, 2013).

Finally, according to the claims of the researchers who investigate complications of endocrine diseases, especially obesity, positive early diagnosis of the disease is essential because it drastically decreases the chances to become overweight (G?ng?r, 2014). Thus, after having viewed and assessed available scientific evidence concerning the positive diagnosis of hypothyroidism and obesity, it is possible to infer that universal screening is critically important because it assists health care professionals in confirming the diagnosis at the early stage and prevents excessive weight gain.

 

Diagnostics: Symptoms Experienced by Patients

Generally speaking, signs and symptoms of hypothyroidism are drastically different and depend on the severity of the disease as well as the level of hormone deficiency. However, numerous research studies provide evidence that continuous fatigue and weight gain are the most common symptoms of hypothyroidism that are the most obvious factors that indicate the development of this endocrine disorder (Ghane & Ahmadi, 2015). However, patients with hypothyroidism may experience a variety of other symptoms, including a puffy face, elevated cholesterol levels in the blood, regular swelling in joints, continuous muscle pain, irregular menstrual periods, long-term depressive symptoms, and many others.

Moreover, health care providers assure that untreated signs and symptoms of hypothyroidism will result in decreased severity and numerous complications in the future, including severe obesity. The researchers Ghane and Ahmadi (2015) who explore common signs and symptoms of hypothyroidism emphasize that one of their research experiments with participation of 680 individuals diagnosed with hypothyroidism indicates that approximately 49% of patients agree that weight gain is one of the most obvious signs and symptoms of hypothyroidism (Ghane & Ahmadi, 2015).

On the contrary, research findings provide data that more than 81% of patients with hypothyroidism experience fatigue and weakness, above 64% suffer from dizziness, and, finally, 56% of participants claim that puffiness in the eyes is also one of the most common symptoms of hypothyroidism (Ghane & Ahmadi, 2015). According to the results of the statistical analysis provided by Adriana (2013), excessive weight gain is one of the most widespread symptoms of hypothyroidism that is closely associated with the feelings of weakness and fatigue (Adriana, 2013). On the contrary, Bello and Bakari (2012) are proponents of the idea that contrary to the popular belief, excessive weight gain and obesity are not common features of hypothyroidism because this endocrine disease is commonly associated with decreased appetite.

However, weight gain may be caused by slow metabolism and fluid accumulation (Bello & Bakari, 2012). As a result, the problem with identifying the most common signs and symptoms of hypothyroidism experienced by patients is that despite fatigue, weakness, and excessive weight gain are the most widely described symptoms caused by this disease, signs, and symptoms experienced by patients with hypothyroidism vary from person to person.

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Diagnostics: Hypothyroidism and Physical Examinations

In several last decades, much attention was paid by the researchers to increased the significance of physical examinations for accurate diagnosis of hypothyroidism. One of the recent publications by Jayakumar (2011) documenting clinical approaches to endocrine disorders proves that neck and thyroid examination are crucially important because the accuracy of detailed physical examinations prevents the progression of threatening symptoms, including fatigue and weight gain (Jayakumar, 2011). Moreover, the results offered by Tonstad, Nathan, Oda, and Fraser (2013) indicate that physical examinations are of utmost importance because hypothyroidism is not always associated with typical signs and symptoms attributed to this disease, and, that is why, accurate and timely diagnosis of the disease is often missed (Tonstad et al., 2013).

Thus, the researchers are proponents of the idea that despite clinicians should not rely solely on physical examination for validation of hypothyroidism, physical examinations are essential because they give the chance to confirm or rule out this endocrine disorder (Tonstad et al., 2013). Finally, the results offered by Ginger (2014) in the research study about a close link between obesity and hypothyroidism suggest that neck and thyroid physical examinations are tremendously important. These procedures ensure an opportunity to establish the accurate functional status of the thyroid, observe possible weight gain and changes in healthy physical appearance, as well as prevent the development of possible complications caused by hypothyroidism in the future, including severe metabolic dysfunctions, myxedema, and many other threatening consequences of hypothyroidism and obesity caused by this disease.

Based on the results of research studies, the following conclusion can be drawn: routine annual physical examinations are vitally important for accurate diagnosis of hypothyroidism because it confirms signs and symptoms experienced by patients with hypothyroidism and prevents the development of long-standing hypothyroidism. Despite isolated physical examinations are characterized by poor diagnostic accuracy for this disease, health care providers should rely on physical examinations in order to maximize the accuracy of diagnostic decisions.

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Diagnostics: Laboratory Work and Tests

Timely laboratory evaluation of hypothyroidism is no less significant than routine physical examinations because a variety of blood tests to measure TSH, T3, T4, and, finally, Free T4 is extensively used for accurate diagnosis of thyroid diseases. The research study offered by Longhi and Radetti (2013) that explore the link between thyroid function and obesity explains that in clinical practice, there are three main scenarios that prove the increased need to focus on laboratory evaluation of thyroid function for diagnosis of hypothyroidism, including suspicion of hypothyroidism on the basis of clinical signs and symptoms experienced by patients, screening for possible thyroid dysfunctions, and, lastly, effective evaluation of treatment for thyroid disease (Longhi & Radetti, 2013).

The researchers Bello and Bakari (2012) claim that a variety of blood tests and non-blood tests are critically important for timely validation of the disease because physical examinations and symptoms experienced by patients cannot confirm possible thyroid dysfunctions. Ghane and Ahmadi (2015) stress that confirming the causes of obesity and diagnosing hypothyroidism, physicians should consider the results of a thyroid-stimulating hormone test because hypothyroidism is the consequence of diminished levels of T3 and T4 in the blood which are commonly known as thyroid hormones (Ghane & Ahmadi, 2015).

The research study by authors Longhi and Radetti (2013), which explores the link between thyroid function and obesity, explains that in clinical practice, there are three main scenarios that prove the increased need to focus on laboratory evaluation of thyroid function for diagnosis of hypothyroidism, including suspicion of hypothyroidism on the basis of clinical signs and symptoms experienced by patients, screening for possible thyroid dysfunctions, and, finally, effective evaluation of treatment for thyroid disease (Longhi & Radetti, 2013).

Thus, the findings of the research studies provide convincing evidence that laboratory tests are critically important because hypothyroidism may be referred to as an elusive disease. However, blood tests not only confirm possible thyroid dysfunctions, but also ensure a chance to physicians to develop effective treatment strategies that will eliminate the progression of threatening symptoms of hypothyroidism, including heart diseases, menstrual disturbances that may result in infertility, and other threatening effects of the disease.

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Pharmacological Treatment

Obesity that results in a huge variety of severe metabolic interactions and drastically increases the risks of developing life-threatening diseases, including diabetes and cardiovascular problems, is often triggered by thyroid dysfunctions, especially hypothyroidism. For several years, much attention and great efforts were devoted to the exploration of the tight link between obesity and hypothyroidism because severe alterations inappropriate thyroid function were often reported in patients who suffer from excessive weight (Longhi & Radetti, 2013).

The researchers have presented convincing data that hypothyroidism results in a significant weight increase and a substantial decrease in metabolic processes. However, the results of research experiments indicate that pharmacological treatment of obesity and excessive weight promoted by hypothyroidism should focus on eliminating medical causes of obesity. In other words, the development of effective treatment strategies oriented to cure hypothyroidism will ensure an opportunity to lose weight and overcome obesity (Longhi & Radetti, 2013).

Biondi and Wartofsky (2014) are the proponents of the idea that the use of thyroid hormone is the most effective method of treatment of excessive weight and obesity caused by hypothyroidism (Biondi & Wartofsky, 2014). The authors of the research study about thyroid hormones emphasize that T4 treatment for hypothyroidism, especially obesity caused by this endocrine dysfunction, positively influences the processes of functioning of the thyroid gland (Biondi & Wartofsky, 2014). Moreover, the researchers claim that levothyroxine is one of the most effective replacement hormones that should be used to treat obesity. However, the authors of the research study warn that this hormone should not be used by patients without hypothyroidism to decrease excessive weight because this hormone is ineffective for weight reduction in individuals who have no thyroid dysfunctions, especially hypothyroidism (Biondi & Wartofsky, 2014).

However, levothyroxine is considered to be the first-line treatment purposed to reduce weight in individuals with hypothyroidism (Biondi & Wartofsky, 2014). In general, the dosage of this thyroid hormone depends on the severity of the disease and is prescribed on an individual basis. However, in many countries, this synthetic hormone is available with numerous dosage strengths, starting from 25 to 300 (Biondi & Wartofsky, 2014). At present, there is a variety of different branded formulations and types of this replacement hormone available in different parts of the words, including Eltroxin and Letrox on the territory of Europe, Thyrox in Asia, and Eutirox in Europe and the United States. Taking into account the pharmacological classification of this supplement, it is important to stress that levothyroxine is a synthetic drug that is absorbed within the first 90 minutes after injection of a tablet (Biondi & Wartofsky, 2014).

The most common side effects of levothyroxine are significant weight loss, insomnia, increased irritability, continuous depression, fever, increased sensitivity to heat, and many other signs and symptoms (Biondi & Wartofsky, 2014). Health care professionals assure that several medications and supplements can easily interfere with absorption and positive effect of levothyroxine, including calcium and iron (Chakera, Pearce, & Vaidya, 2012). Finally, despite the researchers have provided evidence that levothyroxine interacts with more than 600 other types of medications, numerous medications, including cholestyramine and calcium supplements may drastically lessen the amount of levothyroxine that is absorbed by a human body (Chakera et al., 2012).

Lindemann and Webb (2016) claim that ideally, the best and most effective treatment of obesity caused by hypothyroidism should focus on significant losses of fat without reducing skeletal muscle mass. According to scientific evidence, thyromimetics is also included in the list of synthetic analogs of thyroid hormones that are extensively used for the treatment of obesity caused by hypothyroidism. Numerous preclinical studies provide convincing data that these analogs of thyroid hormones do not threaten the health of bones and heart (Lindemann & Webb, 2016).

Sobetirome is one of the most effective antiobesity agents that lead to losses of fat masses (Lindemann & Webb, 2016). In general, dosage as well as the lengths of treatment of sobetirome mainly depends on such important characteristics of age, medical conditions, results of analyses, the severity of obesity caused by hypothyroidism, and, finally, the response of a human organism to treatment. Sobetirome is one of the most effective antiobesity agents that leads to losses of fat masses (Lindemann & Webb, 2016). Numerous experimental and clinical studies confirm that sobetirome expresses a huge potential to manage weight losses. Finally, the most common side effects of sobetirome include elevated serum liver enzymes, considerable muscle pain, only-short term weight loss, and many other health problems.

Finally, sobetirome interacts with many types of medications and is extensively used in conjunction with statins, effective groups of medicines that considerably decrease cholesterol levels (Lindemann & Webb, 2016). Thus, it is possible to summarize that the treatment of obesity in patients with hypothyroidism focuses mainly on synthetic analogs of thyroid hormones that interact with many other medications and do not threaten the overall health of patients. In addition, the orientation of hypothyroidism treatment with levothyroxine and other additional groups of medication often leads to weight loss and normalization of a bodyweight.

Effective Preventive Methods

Except for pharmacological treatment, the researchers in the field of health care differentiate several effective preventive strategies that will ensure a unique opportunity for patients with hypothyroidism to prevent excessive weight gain. To begin with, a well-developed vegan diet is considered to be one of the first effective tactics that ensure a chance not only to decrease the risks of hypothyroidism development but also to prevent obesity (Tonstad et al., 2013). According to the results of experiments with participation of approximately 50 overweight individuals, a vegan diet ensures effective protection against obesity and hypothyroidism because many products included in the dietary list decrease risks of thyroid disease (Tonstad et al., 2013).

Many researchers, including Bello and Bakari (2012), agree to the estimations of Tonstad et al. (2013) that diet is one of the most efficient preventive methods that stop obesity in patients with hypothyroidism (Bello & Bakari, 2012). Health care experts who investigate the link among nutrition, obesity, and hypothyroidism claim that consumption of vegetables, avoidance of chemicals, and reliance only on organic foods are the best dietary recommendations for people who plan to prevent obesity caused by hypothyroidism (Bello & Bakari, 2012). According to the claims of Harris (2014), a healthy and balanced diet plays a fundamental role in maintaining thyroid health and avoiding excessive weight gain.

Harris (2014) studied the impact of a healthy diet on obesity caused by hypothyroidism and claimed that it is imperative for dietitians to be aware of significant metabolic changes associated with hypothyroidism that lead not only to abnormal weight gain but also to difficulty losing excessive weight until stabilization of hormone levels. The researcher emphasizes that a healthy diet to fight obesity caused by hypothyroidism should exclude sugars, including natural food substitutes because it is better to avoid different types of sugar in case people with hypothyroidism either want to lose weight or avoid excessive weight gain (Harris, 2014).

Kevin Dobrzynski, the author of the book The Hypothyroid Diet (2012), has developed an effective exercise guide for the prevention of obesity in hypothyroid patients. The researcher provides convincing evidence that a healthy diet and detoxification should be accompanied by regular physical exercise that should include the following main factors: frequency, intensity, type, and timing (Dobrzynski, 2012). These four characteristics are of utmost importance because they enable people with hypothyroidism to prevent excessive weight gain. The author of the book recommends people to stick to regular physical exercising and make it an integral part of everyday life (Dobrzynski, 2012).

The researchers Rahimi, Zadeh, and Boostani (2013) claim that intensity of exercise is one of the most critical factors that should be considered while reducing excessive weight in patients with hypothyroidism because the intensity of exercising can have a negative impact on weight loss (Rahimi et al., 2013). Therefore, Bello and Bakari (2012) assure that people with hypothyroidism who want to prevent obesity should take into account a type of exercises they perform because, in order to transform a human body and its appearance, people who want to prevent obesity should leave their comfort zone (Bello & Bakari, 2012).

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Finally, taking into consideration the estimations of Buyukgebiz (2013), annual physical examinations and screening are of utmost importance for the prevention of obesity in hypothyroid patients since it ensures a unique opportunity to detect early signs and symptoms of the disease (Buyukgebiz, 2013). Screening and physical examinations for hypothyroidism are essential because these procedures give the chance to prevent the development of the disease in patients with mind and non-specific symptoms (Chakera et al., 2012).

Moreover, the annual physical examination is fundamentally important because it ensures an opportunity to develop effective preventive strategies in order to minimize thyroid dysfunction and develop effective treatment strategies that incorporate pharmacological treatment, regular physical exercising, and healthy nutritional changes (LeFevre, 2015).

Thus, after having shed light on the most effective preventive strategies for obese patients diagnosed with hypothyroidism, it is possible to state that annual screening and regular physical examinations are considered to be the most effective preventive methods because both processes detect signs and symptoms of the disease, ensure a chance to choose effective pharmacological treatment, and develop many other clinical decisions that can affect body weight.

Moreover, the role of a healthy diet and intense physical exercising is no less important for the prevention of obesity in patients with hypothyroidism because hypothyroidism is the consequence of a complex system of environmental, dietary, lifestyle, and, finally, hereditary factors. Thus, it is important to summarize that food which patients with hypothyroidism eat, and the way they exercise have a huge impact on the prevention of obesity caused by hypothyroidism.

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