Community Nursing Diagnosis for Obesity

Obesity

Obesity is the formation of excessive fat deposits in the connective tissue. When there is excessive calorie intake, excess energy is stored as fats in the body for use later. This imbalance in energy causes the release of excess appetite regulation and metabolism hormones leading to obesity. According to the World Health Organization, obesity is rapidly growing all over the world and has more than doubled since 1980. A serious health condition can lead to a number of other health problems, including heart disease, stroke, and diabetes. Obesity is commonly associated with an imbalanced intake of energy and consumption.

Possible causes include using some medications, excessive intake of calories, and existing medical conditions. There are a number of related factors that contribute to obesity, including poor diet, lack of exercise, age, insomnia, stress, genetic makeup, and unhealthy lifestyle routines. Common signs and symptoms of obesity are excess fat deposits in the body, fatigue, difficulty in sleeping, mental issues, and poor performance and physical activities. Obesity is diagnosed by measuring the individual’s BMI (Body Mass Index), determining the cause by taking the family and medical history, physical assessments, and laboratory tests for cholesterol levels. Nursing priorities include assisting individuals in planning weight control methods, being confident and improving their body image, and encouraging healthy lifestyle behaviors that will help the patient avoid relapses. Goals to achieve by discharge are identification of healthy eating patterns and controlled weight, verbalization of positive self-perception, a clearly developed plan for weight control in the future, and a plan to meet patient needs on discharge.

Nursing Care Plans for Obesity

Diagnosis

  1. Imbalanced Nutrition: More Than Body Requirements related to intake of meals exceeding body needs, psychosocial factors, and socioeconomic status as evidenced by excessive body weight, excess fats, and observed dysfunctional eating patterns.
  2. Disturbed Body Image related to psychosocial factors like the patient’s self-view as evidenced by the patient verbalizing negative feelings about their body, fearing rejection by others, and feeling hopeless.
  3. Impaired Social Interaction related to observed discomfort in social settings and disturbed self-concept as evidenced by lack of participation in social gatherings and overly self-consciousness.
  4. Deficient Knowledge related to the presentation of misinterpreted and inaccurate information as evidenced by patients lacking information on nutrition and lack of adherence to exercise and diet plans.

Imbalanced Nutrition: More Than Body Requirements related to intake of meals exceeding body needs, psychosocial factors, and socioeconomic status as evidenced by excessive body weight, excess fats, and observed dysfunctional eating patterns.

Desired outcomes

Nursing Interventions

  • Identify the primary cause of obesity (either organic or nonorganic). Rationale – To formulate specific nursing interventions.
  • Review the patient’s daily food routine (habits, food amounts, calorie intake). Rationale – To give the patient a clear picture of the amount of food intake, related eating habits, and emotions. Identifying eating routines gives a foundation for tailoring a healthy diet program.
  • Discuss the main events and feelings that lead to unhealthy eating. Rationale – To identify whether the cause is an emotional need or physiological hunger.
  • Formulate a healthy diet eating plan with the patient based on the client’s height, age, body build, gender, eating patterns, energy, and nutritional requirements. Identify past healthy eating patterns, outcomes, and factors that interfere with results. Rationale – A healthy diet for weight loss should be balanced with low fats and sufficient proteins for the prevention of lean muscle mass loss. The plan needs to align with normal eating patterns for the patient. Involving the patient in the plan increases the chances of success.
  • Ensure the patient’s weight measurements are done regularly as indicated. Rationale – To confirm the effectiveness of the diet plan and check for signs of irritability and fatigue resulting from rapid weight loss.
  • Determine the patient’s current activities and exercise for achieving desired goals. Rationale – Exercising leads to increased energy and muscle tone, which in turn influences weight loss and enhances a sense of well-being. When a patient is committed,  goals are achieved as per the plan.
  • Discuss the importance of reduced salt intake and the use of diuretic drugs. Rationale – Increased intake of fluids and metabolism of fats may lead to water retention. 

Disturbed Body Image related to psychosocial factors like the patient’s self-view as evidenced by the patient verbalizing negative feelings about their body, fearing rejection by others, and feeling hopeless.

Desired outcomes

  • Patient will verbalize a more realistic self-image.
  • Patient will demonstrate self-acceptance and not an idealized image.
  • Patient will seek information and work toward losing weight.
  • Patient will acknowledge self-responsibility.

Nursing Interventions

  • Determine the patient’s feelings toward being fat and how it affects them. Rationale -Unhealthy eating may be a result of psychological causes- To compensate for no love or defending self against intimacy. The patient’s feelings help to identify the root of these behaviors.
  • Ensure patients have privacy when performing activities like caregiving. Rationale – Individuals usually is sensitive and self-conscious about the body. To make the patient comfortable as they are always sensitive and conscious about body image.
  • Communicate with the patient openly in regard to the behavior without criticizing or judging them. Rationale – Supporting the patient’s weight loss journey will promote control and willingness to focus on the plan.
  • Chart the patient’s weight on a graph regularly. Rationale – To provide evidence of changes in weight to determine progress.
  • Encourage the patient to visualize themself in the desired weight using imagery and practice new eating behaviors. Rationale – Rehearsing mentally will help the patient plan for change and deal with changes in self-image.
  • Help the patient remember patterns that enabled him to cope in relation to food in the family of origin and find out how these impact the situation currently. Rationale – Children learn and adapt some patterns from a family setting as parents are always their role models. If reinforced positively, love and affection at home can substitute the eating urge.

Impaired Social Interaction related to observed discomfort in social settings and disturbed self-concept as evidenced by lack of participation in social gatherings and overly self-consciousness.

Desired outcomes 

  • Patient will verbalize being aware of emotions leading to poor social interactions.
  • Patient will be involved in achieving positive social behavior changes and interpersonal relationships.

Nursing Interventions

  • Reviewing relationships and social behavior patterns in the family. Rationale – Family is the primary point of contact and interaction. Identifying factors and activities affecting the patient can help formulate interventions easily.
  • Encourage the patient to express emotions and how they perceive problems. Rationale -To identify causes of poor interactions and socialization.
  • Assess how the patient uses defense mechanisms and coping skills and let them list down stressors. Rationale – Determining coping skills will be helpful in the process of losing weight. Defense mechanisms influence lonely feelings and isolation behaviors. Listing down stressors will mitigate discomfort and feelings and will take steps to change effectively.
  • Role play with the patient is a new way to solve situations and behaviors that have been identified. Rationale – To enable the patient to feel safe, safe, and comfortable in such situations.
  • Encourage the patient to use positive self-talk such as saying to self “I am fine,” or “I can enjoy social interactions.” Rationale – To enhance confidence and enable the patient to take steps for positive change.
  • Refer the patient to indulge in individual or family therapy as indicated. Rationale – Support systems in therapy relieve the burden by supporting and providing encouragement.

Deficient Knowledge related to the presentation of misinterpreted and inaccurate information as evidenced by patients lacking information on nutrition and lack of adherence to exercise and diet plans.

Desired outcomes 

  • Patient will verbalize a clear understanding of the importance of changing lifestyle for weight loss.
  • Establish desired individual goals and plan interventions to attain the goals.
  • Patients will seek information related to weight loss and nutrition.

Nursing Interventions

  • Assess the level of nutritional knowledge and the most critical needs as per the patient. Rationale – To help in coming up with interventions that will help create a care plan and account for the patient’s perspective.
  • Teach the different patients ways to avoid thinking about food (divert to activities like reading or swimming). Rationale -The activities will help in relaxation and the mind will be diverted from focusing on food. 
  • Identify informational sources like community classes, books, groups and tapes. Rationale – Exploring information improves patient learning. Groups offer support as they look towards achieving the same goal.
  • Encourage patients to use alternative methods like mechanical equipment. Rationale – To ensure continuity of planned exercises, especially during lapses in time, weather or travel.

References

Centers for Disease Control and Prevention. (2017). Adult obesity facts. 

Dickerson, R.N. (2014). Obesity. In K.A. Davis & S.H. Rosenbaum (Eds.), Surgical metabolism: The metabolic care of the surgical patients (pp.127-146). Springer.

Lee, H., Lee, I., & Choue, R. (2013). Obesity, inflammation, and diet. Pediatric Gastroenterology, Hepatology & Nutrition, 16(3), 143-152.