Introduction
Obesity is defined as a complex, chronic disorder of having an excessive fat accumulation of approximately 20% above the baseline weight associated with gender, age, and height.
Obesity isn’t just a cosmetic concern. It’s a medical problem that increases the risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure, and certain cancers.
There are many reasons why some people have difficulty losing weight. Usually, obesity results from inherited physiological and environmental factors, combined with diet, physical activity, and exercise choices.
A healthier diet, increased physical activity, and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.
This blog post discusses about obesity; its symptoms, causes, nursing care plans and interventions with some examples .As you follow along, remember that our qualified writers are always ready to help in any of your nursing assignments. All you need to do is place an order with us!
Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice. Nursing Care Plans For Obesity
Symptoms of Obesity
Body mass index (BMI) is often used to diagnose obesity. To calculate BMI, multiply weight in pounds by 703, divide by height in inches, and then divide again by height in inches. Or divide weight in kilograms by height in meters squared.
BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0 and higher Obesity
For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn’t directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don’t have excess body fat.
Many doctors also measure a person’s waist circumference to help guide treatment decisions. Weight-related health problems are more common in men with a waist circumference over 40 inches (102 centimeters) and in women with a waist measurement over 35 inches (89 centimeters).
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Causes of Obesity
Although there are genetic, behavioral, metabolic, and hormonal influences on body weight, obesity occurs when people take in more calories than they burn through normal daily activities and exercise. The body stores these excess calories as fat.
In the United States, most people’s diets are too high in calories — often from fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.
Many people who live in Western countries now have much less physically demanding jobs, so they don’t tend to burn as many calories at work. Even daily activities use fewer calories, courtesy of conveniences such as remote controls, escalators, online shopping, and drive-through banks.
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Risk Factors of Obesity
Obesity usually results from a combination of causes and contributing factors:
Family inheritance and influences
The genes inherited from parents may affect the amount of body fat stored and distributed that fat. Genetics may also play a role in how efficiently the body converts food into energy, how the body regulates appetite, and how the body burns calories during exercise.
Obesity tends to run in families. That’s not just because of the genes they share. Family members also tend to share similar eating and activity habits.
Lifestyle choices
Unhealthy diet. A diet that’s high in calories lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain.
Liquid calories. People can drink many calories without feeling full, especially calories from alcohol. Other high-calorie beverages can contribute to significant weight gain, such as sugared soft drinks.
Inactivity. If you have a sedentary lifestyle, you can easily take in more calories every day than you burn through exercise and routine daily activities. Looking at computer, tablet, and phone screens is a passive activity. The number of hours spent in front of a screen is highly associated with weight gain.
Certain diseases and medications
In some people, obesity can be traced to a medical cause, such as Prader-Willi syndrome, Cushing syndrome, and other conditions. Medical problems, such as arthritis, can also lead to decreased activity, resulting in weight gain.
Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids, and beta-blockers.
Social and economic issues
Social and economic factors are linked to obesity. Avoiding obesity is difficult if you don’t have safe areas to walk or exercise. Similarly, you may not have been taught healthy ways of cooking, or you may not have access to healthier foods. In addition, the people you spend time with may influence your weight — you’re more likely to develop obesity if you have friends or relatives with obesity.
Age
Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. Generally, lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs and make it harder to keep off excess weight. If you don’t consciously control what you eat and become more physically active as you age, you’ll likely gain weight.
Other factors
Pregnancy. Weight gain is common during pregnancy. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
Quitting smoking. Quitting smoking is often associated with weight gain. It can lead to enough weight gain to qualify as obesity. Often, this happens as people use food to cope with smoking withdrawal. However, in the long run, quitting smoking is still a greater benefit to your health than continuing to smoke. Your doctor can help you prevent weight gain after quitting smoking.
Lack of sleep. Not getting enough sleep or getting too much sleep can cause changes in hormones that increase appetite. You may also crave foods high in calories and carbohydrates, contributing to weight gain.
Stress. Many external factors that affect mood and well-being may contribute to obesity. People often seek more high-calorie food when experiencing stressful situations.
Microbiome. Your gut bacteria are affected by what you eat and may contribute to weight gain or difficulty losing weight.
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Complications of Obesity
People with obesity are more likely to develop several potentially serious health problems, including:
Heart disease and strokes. Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.
Type 2 diabetes. Obesity can affect the way the body uses insulin to control blood sugar levels. This raises the risk of insulin resistance and diabetes.
Certain cancers. Obesity may increase the risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney, and prostate.
Digestive problems. Obesity increases the likelihood of developing heartburn, gallbladder disease, and liver problems.
Sleep apnea. People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
Osteoarthritis. Obesity increases the stress placed on weight-bearing joints and promotes inflammation within the body. These factors may lead to complications such as osteoarthritis.
Severe COVID-19 symptoms. Obesity increases the risk of developing severe symptoms if you become infected with the virus that causes coronavirus disease 2019 (COVID-19). People who have severe cases of COVID-19 may require treatment in intensive care units or even mechanical assistance to breathe.
Quality of life
Obesity can diminish the overall quality of life. You may not be able to do physical activities that you used to enjoy. You may avoid public places. People with obesity may even encounter discrimination.
Other weight-related issues that may affect your quality of life include:
- Depression
- Disability
- Shame and guilt
- Social isolation
- Lower work achievement
Diagnosis of Obesity for nursing care plans for obesity
- Measurement of body mass index
- Review the patient’s medical and family history – to determine the cause of obesity, whether it is organic (presence of chromosomal aberrations, insulin resistance, etc.)
- Physical examination and assessment – the attending physician may implement measurements in the waist circumference to aid with diagnosis. The patient’s status is usually included (e.g., blood pressure, heart rate, and temperature).
- Blood tests to evaluate cholesterol or triglyceride level.
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Nursing Care Plans for Obesity Based on Diagnosis
Nursing care plans for obesity 1: Diagnosis – Imbalanced Nutrition: More Than Body Requirements
May be related to: (nursing care plans for obesity)
- Food intake that exceeds body needs
- Psychosocial factors
- Socioeconomic status
Possibly evidenced by:
- Weight of 20% or more over optimum body weight; excess body fat by skinfold/other measurements
- Reported/observed dysfunctional eating patterns, intake more than body requirements
Desired Outcomes
- Identify inappropriate behaviors and consequences associated with overeating or weight gain.
- Demonstrate change in eating patterns and involvement in an individual exercise program.
- Display weight loss with optimal maintenance of health.
| Nursing Interventions | Rationale |
| Review individual causes for obesity (organic or nonorganic). | Identifies and influences the choice of some interventions. |
| Carry out and review daily food diary (caloric intake, types and amounts of food, eating habits). | Provides the opportunity for the individual to focus on a realistic picture of the amount of food ingested and corresponding eating habits and feelings. Identifies patterns requiring a change or a base on which to tailor the dietary program. nursing care plans for obesity |
| Explore and discuss emotions and events associated with eating. | Helps identify when a patient is eating to satisfy an emotional need rather than physiological hunger. |
| Formulate an eating plan with the patient, using knowledge of individual’s height, body build, age, gender, and individual patterns of eating, energy, and nutrient requirements. Determine which diets and strategies have been used, results, individual frustrations, and factors interfering with success. | Although there is no basis for recommending one diet over another, a good reducing diet should contain foods from all basic food groups focusing on low-fat intake and adequate protein intake to prevent loss of lean muscle mass. Keeping the plan as similar to the patient’s usual eating pattern is helpful as possible. A plan developed with and agreed to by the patient is more likely to be successful. nursing care plans for obesity |
| Emphasize the importance of avoiding fad diets. | Elimination of needed components can lead to metabolic imbalances like excessive reduction of carbohydrates can lead to fatigue, headache, instability and weakness, and metabolic acidosis (ketosis), interfering with the effectiveness of the weight loss program. |
| Discuss the need to give self permission to include desired or craved food items in the dietary plan. | Denying self by excluding desired or favorite foods result in the sense of deprivation and feelings of guilt and failure when an individual “succumbs to temptation.” These feelings can sabotage weight loss. |
| Be alert to binge eating and develop strategies for dealing with these episodes (substituting other actions for eating). | The patient who binges experiences guilt about it, which is also counterproductive because negative feelings may sabotage further weight loss efforts. |
| Identify realistic increment goals for weekly weight loss. | Reasonable weight loss (1–2 lb per wk) results in more lasting effects. Excessive and rapid loss may result in fatigue and irritability and ultimately lead to failure to meet weight loss goals. Motivation is more easily sustained by meeting “stair-step” goals. |
| Weigh periodically as individually indicated, and obtain appropriate body measurements. | Provides information about the effectiveness of the therapeutic regimen and visual evidence of the success of the patient’s efforts. (During hospitalization for controlled fasting, daily weighing may be required. Weekly weighing is more appropriate after discharge.) |
| Determine current activity levels and plan a progressive exercise program (walking) tailored to the individual’s goals and choice. | Exercise furthers weight loss by reducing appetite; increasing energy; toning muscles; and enhancing cardiac fitness, sense of well-being, and accomplishment. Commitment on the part of the patient enables the setting of more realistic goals and adherence to the plan. |
| Develop an appetite reeducation plan with the patient. | Signals of hunger and fullness often are not recognized, have become distorted, or are ignored. |
| Emphasize the importance of avoiding tension at mealtimes and not eating too quickly. | Reducing tension provides a more relaxed eating atmosphere and encourages more leisurely eating patterns. This is important because a period of time is required for the appestat mechanism to know the stomach is full. |
| Encourage the patient to eat only at a table or designated eating place and to avoid standing while eating. | Techniques that modify the behavior may help avoid diet failure. |
| Discuss restriction of salt intake and diuretic drugs if used. | Water retention may be a problem because of increased fluid intake and fat metabolism. |
| Reassess calorie requirements every 2–4 wk; provide additional support when plateaus occur. | Changes in weight and exercise necessitate changes in plan. As weight is lost, changes in metabolism occur, resulting in plateaus when weight remains stable for periods of time. This can create distrust and lead to accusations of “cheating” on caloric intake, which is not helpful. A patient may need additional support at this time. |
| Consult with a dietitian to determine caloric and nutrient requirements for individuals’ weight loss. | Several different formulas can calculate individual intake, but weight reduction is based on the basal caloric requirement for 24 hr, depending on the patient’s sex, age, current and desired weight, and length of time estimated to achieve the desired weight. Note: Standard tables are subject to error when applied to individual situations, and circadian rhythms and lifestyle patterns need to be considered. |
| Provide medications as indicated: | |
| Appetite-suppressant drugs like diethylpropion (Tenuate), mazindol (Sanorex), Sibutramine (Meridia); | May be used with caution and supervision at the beginning of a weight loss program to support a patient during the stress of behavioral and lifestyle changes. They are only effective for a few weeks and may cause addiction problems in some people. |
| Hormonal therapy like thyroid (Euthroid), levothyroxine (Synthroid); | May be necessary when hypothyroidism is present. When no deficiency is present, replacement therapy is not helpful and may actually be harmful. Note: Other hormonal treatments, such as human chorionic gonadotropin (HCG), although widely publicized, have no documented evidence of value. |
| Orlistat (Xenical); | Lipase inhibitor blocks absorption of approximately 30% of dietary fat. Facilitates weight loss and maintenance when used in conjunction with a reduced-calorie diet. It also reduces the risk of regaining after weight loss. |
| Vitamin, mineral supplements. | Obese individuals have large fuel reserves but are often deficient in vitamins and minerals. Note: Use of Xenical inhibits the absorption of water-soluble vitamins and beta-carotene. Vitamin supplements should be given at least 2 hr before or after Xenical. |
| Hospitalize for fasting regimen and stabilization of medical problems, when indicated. | Aggressive therapy and support may be necessary to initiate weight loss, although fasting is not generally a treatment of choice. A patient can be monitored more effectively in a controlled setting to minimize complications such as postural hypotension, anemia, cardiac irregularities, and decreased uric acid excretion with hyperuricemia. |
| Prepare for surgical interventions (gastric partitioning or bypass) as indicated. | These interventions may be necessary to help the patient lose weight when obesity is life-threatening. |
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Nursing care plans for obesity: Diagnosis – Disturbed Body Image
nursing care plans for obesity May be related to:
- Biophysical/psychosocial factors such as patient’s view of self (slimness is valued in this society, and mixed messages are received when thinness is stressed)
- Family/subculture encouragement of overeating
- Control, sex, and love issues
Possibly evidenced by:
- Verbalization of negative feelings about the body (mental image often does not match physical reality)
- Fear of rejection/reaction by others
- Feelings of hopelessness/powerlessness
- Preoccupation with change (attempts to lose weight)
- Lack of follow-through with diet plan
- Verbalization of powerlessness to change eating habits
Desired Outcomes
- Verbalize a more realistic self-image.
- Demonstrate some acceptance of self as is, rather than an idealized image.
- Seek information and actively pursue appropriate weight loss.
- Acknowledge self as an individual who has responsibility for self.
| Nursing Interventions | Rationale |
| Determine the patient’s view of being fat and what it does for the individual. | The mental image includes our ideal and is usually not up-to-date. Fat and compulsive eating behaviors may have deep-rooted psychological implications (compensation for lack of love and nurturing or defense against intimacy). |
| Provide privacy during care activities. | An individual usually is sensitive and self-conscious about their body. |
| Promote open communication avoiding criticism and judgment about patient’s behavior. | Supports patient’s own responsibility for weight loss, enhances the sense of control, and promotes the willingness to discuss difficulties and setbacks and problem-solve. Note: Distrust and accusations of “cheating” on caloric intake are not helpful. |
| Outline and clearly state the responsibilities of patient and nurse. | It is helpful for each individual to understand the area of their own responsibility in the program so that misinformation does not arise. |
| Graph weight on a weekly basis. | Provides ongoing visual evidence of weight changes (reality orientation). |
| Encourage the patient to use imagery to visualize themself at the desired weight and to practice handling new behaviors. | Mental rehearsal is very useful in helping the patient plan for and deals with anticipated changes in self-image or occasions that may arise (family gatherings, special dinners) where constant decisions about eating many foods will occur. |
| Provide information about the use of makeup, hairstyles, and ways of dressing to maximize figure assets. | Enhances feelings of self-esteem; promotes improved body image. |
| Encourage buying clothes instead of food treats as a reward for weight loss. | Properly fitting clothes enhance the body image as small losses are made, and the individual feels more positive. Waiting until the desired weight loss is reached can become discouraging. |
| Suggest the patient dispose of “fat clothes” as weight loss occurs. | Removes the “safety valve” of having clothes available “in case” the weight is regained. Retaining fat clothes can convey the message that weight loss will not occur and be maintained. |
| Have the patient recall food-related coping patterns in the family of origin and explore how these may affect the current situation. | Parents act as role models for the child. Maladaptive coping patterns (overeating) are learned within the family system and are supported through positive reinforcement. The parent may substitute food for affection and love, and eating is associated with a feeling of satisfaction, becoming the primary defense. |
| Determine relationship history and the possibility of sexual abuse. | May contribute to current issues of self-esteem and patterns of coping. |
| Identify patient’s motivation for weight loss and assist with goal setting. | The individual may harbor a repressed feeling of hostility, which may be expressed inward on the self. Because of a poor self-concept, the person often has difficulty with relationships. Note: When losing weight for someone else, the patient is less likely to be successful and maintain weight loss. |
| Be alert to the patient and SO’s myths about weight and weight loss. | Beliefs about what an ideal body looks like or unconscious motivations can sabotage efforts to lose weight. Some of these include the feminine thought of “If I become thin, men will pursue me or rape me”; the masculine counterpart, “I don’t trust myself to stay in control of my sexual feelings”; as well as issues of strength, power, or the “good cook” image. |
| Assist patient in identifying feelings that lead to compulsive eating. Encourage journaling. | Awareness of emotions that lead to overeating can be the first step in behavior change (people often eat because of depression, anger, and guilt). |
| Develop strategies for doing something besides eating for dealing with these feelings, such as talking with a friend. | Replacing eating with other activities helps retrain old patterns and establish new ways to deal with feelings. |
| Help staff be aware of and deal with their own feelings when caring for a patient. | Judgmental attitudes, feelings of disgust, anger, and weariness can interfere with care and be transmitted to the patient, reinforcing negative self-concept and image. |
| Refer to community support and therapy group. | Support groups can provide companionship, enhance motivation, decrease loneliness and social ostracism, and give practical solutions to common problems. Group therapy can be helpful in dealing with underlying psychological concerns. |
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Nursing care plans for obesity : Diagnosis – Impaired Social Interaction
May be related to:
- Verbalized or observed discomfort in social situations
- Self-concept disturbance
Possibly evidenced by
- Reluctance to participate in social gatherings
- Verbalization of a sense of discomfort with others
Desired Outcomes
- Verbalize awareness of feelings that lead to poor social interactions.
- Become involved in achieving positive changes in social behaviors and interpersonal relationships.
| Nursing Interventions | Rationale |
| Review family patterns of relating and social behaviors. | Social interaction is primarily learned within the family of origin. When inadequate patterns are identified, actions for change can be instituted. |
| Encourage the patient to express feelings and perceptions of problems. | Helps identify and clarify reasons for difficulties in interacting with others (may feel unloved and unlovable or insecure about sexuality). |
| Assess the patient’s use of coping skills and defense mechanisms. | May have coping skills that will be useful in the process of weight loss. Defense mechanisms used to protect the individual may contribute to feelings of aloneness and isolation. |
| Have the patient list behaviors that cause discomfort. | Identifies specific concerns and suggests actions that can be taken to effect change. |
| Involve in role-playing new ways to deal with identified behaviors and situations. | Practicing these new behaviors enables the individual to become comfortable with them in a safe situation. |
| Discuss negative self-concepts and self-talk, “No one wants to be with a fat person,” “Who would be interested in talking to me?” | It may be impeding positive social interactions. |
| Encourage the use of positive self-talk such as telling one-self “I am OK,” or “I can enjoy social activities and do not need to be controlled by what others think or say.” | Positive strategies enhance feelings of comfort and support efforts for change. |
| Refer for ongoing family or individual therapy as indicated. | Patient benefits from the involvement. To provide support and encouragement. |
Related Questions
How can nurses help with obesity? Supports the patient’s own responsibility for weight loss, enhances the sense of control, and promotes the willingness to discuss difficulties and setbacks and problem-solve. Note: Distrust and accusations of “cheating” on caloric intake are not helpful.
What are some interventions for obesity? Formulate an eating plan with the patient, using knowledge of individual’s height, body build, age, gender, and individual patterns of eating, energy, and nutrient requirements. Determine which diets and strategies have been used, results, individual frustrations, and factors interfering with success.
References
Related FAQs
1. What is obese obesity?
Obesity, also called corpulence or fatness, excessive accumulation of body fat, usually caused by the consumption of more calories than the body can use.
2. What are the health risks of obesity?
Obesity isn’t just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.
3. What is obesity and how can you avoid it?
Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers. There are many reasons why some people have difficulty avoiding obesity.
4. What is obesity and how is it treated?
Obesity is a medical condition in which excess body fat has accumulated to such an extent that it has a negative effect on health.
5. Community Health Nursing Diagnosis Examples for Obesity
The nursing process in a community involves health planning. It is a continual social process in which data in a certain area is collected and analyzed in order to establish a strategy for generating new ideas, meeting identified