4 Obesity Nursing Care Plans

February 28, 2014

Obesity is a complex disorder involving an excess accumulation of body fat at least 20% over average desired weight for age, sex, and height or a body mass index of greater than 27.8 for men and greater than 27.3 for women. Obesity isn’t just a cosmetic concern. It increases your risk of diseases and health problems such as heart disease, diabetes, and high blood pressure.

It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person’s weight is greater than what’s considered healthy for his or her height.

Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active.

Nursing Care Plans

Nursing care management for patients with obesity includes identification of inappropriate behaviors that cause obesity, preparing a diet plan, determining nutritional knowledge, and providing information.

Here are four (4) nursing care plans (NCP) and nursing diagnosis for obesity:

Deficient Knowledge

Deficient Knowledge: Absence or deficiency of cognitive information related to specific topic.

May be related to

Lack of/misinterpretation of information
Lack of interest in learning, lack of recall
Inaccurate/incomplete information presented

Possibly evidenced by

Statements of lack of/request for information about obesity and nutritional requirements
Verbalization of problem with weight reduction
Inadequate follow-through with previous diet and exercise instructions

Desired Outcomes

Client will verbalize understanding of need for lifestyle changes to maintain/control weight.
Client will establish individual goal and plan for attaining that goal.
Client will begin to look for information about nutrition and ways to control weight.

Nursing Interventions	Rationale
Determine level of nutritional knowledge and what patient believes is most urgent need.	Necessary to know what additional information to provide. When patient’s views are listened to, trust is enhanced.
Identify individual holistic long-term goals for health (lowering blood pressure, controlling serum lipid and glucose levels).	A high relapse rate at 5-year follow-up suggests obesity cannot be reliably reversed and cured. Shifting the focus from initial weight loss and percentage of body fat to overall wellness may enhance rehabilitation.
Provide information about ways to maintain satisfactory food intake in settings away from home.	“Smart” eating when dining out or when traveling helps individual manage weight while still enjoying social outlets.
Identify other sources of information like books, tapes, community classes, groups.	Using different avenues of accessing information furthers patient’s learning. Involvement with others who are also losing weight can provide support.
Emphasize necessity of continued follow-up care and counseling, especially when plateaus occur.	As weight is lost, changes in metabolism occur, interfering with further loss by creating a plateau as the body activates a survival mechanism, attempting to prevent “starvation.” This requires new strategies and aggressive support to continue weight loss.
Identify alternatives to chosen activity program to accommodate weather, travel, and so on. Discuss use of mechanical devices and equipment for reducing.	Promotes continuation of program. Note: Fat loss occurs on a generalized overall basis, and there is no evidence that spot reducing or mechanical devices aid in weight loss in specific areas; however, specific types of exercise or equipment may be useful in toning specific body parts.
Determine optimal exercise heart rate. Demonstrate proper technique to monitor pulse.	Promotes safety as patient exercises to tolerance, not peer pressure.
Discuss necessity of good skin care, especially during summer months and following exercise.	Prevents skin breakdown in moist skin folds.
Identify alternative ways to “reward” self and family for accomplishments or to provide solace.	Reduces likelihood of relying on food to deal with feelings.
Encourage involvement in social activities that are not centered around food (bike ride or nature hike, attending musical event, group sporting activities).	Provides opportunity for pleasure and relaxation without “temptation.” Activities and exercise may also use calories to help maintain desired weight.