Donna Riopelle tries to convince her overweight patients to change their eating and exercise habits, but it can be difficult. She says her patients are paying more attention to her guidance now that she has research to back it up.
As her capstone project for the Doctor of Nursing Practice program at Samuel Merritt University (SMU), Riopelle investigated what would be the most effective tool for motivating overweight people to understand their disease risk and make lifestyle changes.
She compared two different body fat measurements; the body mass index (BMI), a commonly used measurement of body fat based on height and weight, versus the difference between waist and hip circumference. Previous studies have shown that the proportion of height-to-weight appears to be less important than the waist-to-hip ratio as a predictor of mortality, particularly for older adults.
Over 12 weeks, Riopelle studied the responses of 15 middle-aged men diagnosed as prediabetic with a control group. She found that those counseled using the body-shape tool lost more weight and had more favorable blood sugar levels than the group that relied on the BMI.
“Now I have significant results that the tool is trustworthy,” she says. “Because I did the study, my patients pay attention even more.”
Riopelle conducted her research at the Institute for Weight Loss and Anti-Aging, an outpatient practice she started 27 years ago as a nurse practitioner in San Ramon with her physician husband that focuses on preventative medicine as well as cosmetic dermatology.
“I feel passionate about helping patients lose weight and am even more passionate about helping them keep it off,” says Riopelle. “They feel better about themselves mentally and physically, and will have less complications as they grow older.”
More than 70 percent of American adults age 20 years and over are overweight or obese, according to 2013-14 data from the Centers for Disease Control and Prevention. Excess body fat increases the risk for coronary artery disease -- heart attacks and strokes --diabetes, hypertension, and numerous cancers.
Riopelle, who won the Outstanding Doctor of Nursing Practice Award at SMU’s 2017 Commencement, says working alongside the program’s other graduate nurses helped her to develop her fieldwork skills.
“I never did research before,” she says. “It taught me how, and I find it very gratifying.”
Riopelle’s research also won professional recognition. She submitted a scientific poster presentation in the research and information exchange forum at the 2017 Western Institute of Nursing conference and won first place among 300 entries.
While she knew waist-to-hip ratio is the most accurate reflection of excess body fat, Riopelle was also aware that it’s traditionally harder to counsel men than women to lose weight. Women, she said, tend to go on diets more often and are more inspired by wanting to look better.
“Men become more motivated when I counsel them about disease risk,” she says.
Riopelle has several approaches to weight loss. Because she treats so many diabetics, she tends to advise her overweight patients to consume more low-glycemic carbohydrate foods -- like non-starchy vegetables and lean proteins -- and to limit portion size. For weight maintenance, she encourages the adoption of lifelong healthy habits such as exercise and calorie control.
SMU School of Nursing Professor Paulina Van, PhD, who was Riopelle’s capstone chair and mentor in the DNP program, says she was so impressed with her student’s scholarship that she became her patient. Since her first appointment in January, Van says she has lost 50 pounds and is the healthiest she has been in years.
“Donna is a consummate professional and approaches the care of patients with the utmost compassion and care,” says Van. “She taps into the unique needs and preferences of each patient.”