Obesity

Obesity

Domain 2. Nutrition
Class 1. Ingestion
Diagnostic Code: 00232
Nanda label: Obesity
Diagnostic focus: Obesity

Introduction to Nursing Diagnosis Obesity

Oftentimes, being overweight or obese can have negative implications on a person’s physical and mental wellbeing. While obesity can be caused by various factors such as genetics, environment, and lifestyle, nurses play an important role in successfully diagnosing and treating it. A nursing diagnosis for obesity, when identified early and accurately, is a useful tool for nurses to gain a better understanding of underlying factors contributing to the issue and guide them to form appropriate intervention strategies.

NANDA Nursing Diagnosis Definition

NANDA International, also known as the North American Nursing Diagnosis Association, defines Obesity as “excessive accumulation of body fat relative to height and weight that is associated with increased risk of morbidity and mortality”.

Defining Characteristics (Subjective and Objective Data):

Subjective data may include complaints of feeling unduly fatigued, having difficulty manipulating one’s body, having negative and/or distorted body image, facing social oppression due to size or shape and followed by behaviors such as restrictive eating and purging, eating in large binges, or exercising excessively. Whereas for objective data, nurses may assess for a body mass index over 30, circumferences of the waist, hips and mid-arm sites, anthropometric measurements of height, weight and percent body fat, physical reactions to a bout of exercise, hydration levels and/or edema, and lastly level of fatigue.

Related Factors

Socioeconomic: Generally patients from lower-income backgrounds tend to experience higher rates of obesity due to limited access to healthy food options and limited resources for physical activities.

Lifestyle: Low levels of physical activity and unhealthy dietary habits are known to be the main contributing factors to obesity. High stress levels along with overeating or consuming processed and/or fast foods could also be considered responsible.

Genetics: Predisposition to obesity can be inherited through genes and pass down through generations.

Medication: Certain types of medications, specifically those that contain Corticosteroids, can have a direct effect on an individual’s weight and make them prone to gaining weight quickly.

At Risk Population

Children: Although not strictly at a genetic level, the concept of obesogenic environments can contribute to younger people’s predisposition to becoming obese. This means that their environments are more conducive to them becoming overweight or obese due to unhealthy eating habits and sedentary lifestyle.

Adolescents: Around this age, teens typically begin to experiment more and it becomes less common for parents to influence their dietary choices.

Elderly: As a result of diminished physical mobility, elderly people commonly become more obese due to lack of physical activity.

Women: Women are at an especially higher risk for becoming obese due to hormonal imbalances during pregnancy, menopause and menarche, meaning they experience huge jumps in body weight over very short periods.

Associated Conditions

The consequences of having a higher body mass index than normal can lead to some serious health issues. Some examples of relatively frequent related conditions include diabetes, coronary heart disease, hyperlipidemia, hypertension (high blood pressure), stroke, respiratory problems, sleep apnea, and osteoarthritis.

Suggestions of Use

In order to successfully assess and treat obesity, the nurse must consider medical history, psychological concerns, the patient’s home and family situation, nutrition, lifestyle choices and any potential barriers to behavioral change. Formulating an obesity nursing diagnosis and treatment plan requires thoughtfulness and emotional intelligence. Before settling on an obesity nursing diagnosis and plan of care, nurses should involve collaboration from members of the medical team, family members, and the patient.

Suggested Alternative NANDA Nursing Diagnosis

NANDA also lists two other nursing diagnoses pertaining to perceived health status and body structure malfunctions; Nutrisional Imbalance Less than That Required for Metabolic Needs and Alterations in Body Image. Nutritional Imbalance Less than That Required for Metabolic Needs, is applicable in the situation where the patient’s diet is not providing sufficient nutrients. As a result, this leads to decreases in metabolic function and developing obesity. On the other hand, with Alterations in Body Image, the patient experiences distress due to dissatisfaction with their own physical features. With this diagnosis in mind, nurses must focus on restoring the patient’s sense of self-esteem and teach them to embrace and maintain natural beauty.

Usage Tips

In order to properly and accurately diagnose and intervene for cases of obesity, nurses need to effectively gather and analyze client data. Information needs to be obtained from medical records, interviews, laboratory findings and physical examination in order to properly assess the patient’s current health status. For the development and implementation phase of the plan of care, nurses should be aware of the cultural implications of the various treatments, especially if they apply to different religious beliefs, since they can create challenges during compliance. Lastly, before any intervention or plan is put into place, the patient’s goals and values need to be taken into account in order for it to be successful and accepted by the patient.

NOC Outcomes

NOC stands for Nursing Outcomes Classification and lists a set of standardized outcomes that represent different levels of patient well-being. These outcomes can help medical personnel track patient progress towards desired health outcomes. They include but are not limited to: Weight Control, Nutritional Status, Hydration Status, Physical Mobility, Mood, Self-Care and Self-Concept. With Weight Control, we must strive for the patient to achieve desired and healthy body mass index relative to their own height and weight. For Nutritional Status, the patient must have a balance between energy intake and expenditure. Additionally, Hydration Status must be closely monitored and often incorporates specialty diets. Physical Mobility drives the importance of increasing the patient’s daily activity and/or limit sedentary behavior as much as possible. Mental health is a fundamental aspect of recovery, therefore Mood should be monitored closely and addressed if necessary. As for Self-Care and Self-Concept, these are both key factors in promoting positive self-identity and successful treatment.

Evaluation Objectives and Criteria

Evaluating the patient’s progress is an important part of ensuring success as well as a way of tracking potential compliances. Nurses can use five criteria for evaluating the success of a plan of action for treatment of obesity. These five criteria includes: whether the patient has identified risk factors for obesity, undergone proper dietary assessment, practiced an appropriate physical activity, made modifications to lifestyle, and finally reached therapeutic goals.

NIC Interventions

NIC stands for Nursing Interventions Classification and provides nursing interventions for specific problems and diagnoses. Two primary interventions that are available strengthen the support of weight control are Consultation and Nutrition Therapy. Consultation is beneficial because it allows patients to consult with specialized professionals such as dieticians and nutritionists in order to optimize their dietary intake. Nutrition Therapy promotes healthy eating habits as well as avoiding processed or sugary foods, and incorporating more nutrient dense foods into their meals such as vegetables, dairy products, grains, and lean meat. It also aims to teach patients about portion control by limiting extreme calorie intakes.

Nursing Activities

Some general nursing activities that can be helpful in treating obesity include: patient education, counseling, monitoring progress, behavior changes, and establishing long-term plans. Patient education works to helps foster positive lifestyle changes, especially regarding dietary selections and physical activity. Counseling is beneficial because it provides a safe space to discuss fears and concerns with a knowledgeable leader. Furthermore, tracking progress with numerical statistics is a great way to ensure that goals are being met. Finally, motivating patients to make small yet meaningful changes in their eating and exercise habits will help solidify those positive behaviors with time.

Conclusion

Obesity is a serious problem that affects the mental and physical health of many people across the globe. While genetics, environment, and lifestyle all factor into the equation of being overweight or obese, nurses play a vital role in properly assessing and intervening cases effectively. By utilizing concepts such as NANDA’s nursing diagnosis for obesity and its related factors, nurses are better equipped to formulate the ideal treatment plan for their patients to reach their goals safely and correctly.

5 FAQs

  • What is a nursing diagnosis for obesity? Obese individuals assume an increased risk for morbidity and mortality, making a proper nursing diagnosis pivotal in providing effective care. NANDA International defines Obesity as an excessive accumulation of body fat relative to height and weight.
  • What is the purpose of a nursing diagnosis? A nursing diagnosis provides nurses with a better understanding of the factors contributing to the obesity problem and is imperative in forming an appropriate intervention plan.
  • At-risk populations for obesity? Children, adolescents, elderly people, and women are at an especially higher risk for developing obesity due to hormonal imbalances, lower-income backgrounds, and/or diminished physical mobility.
  • What are the suggested interventions for obesity?Two primary interventions that are available strengthen the support of weight control are Consultation and Nutrition Therapy. Additionally, patient education and monitoring progress as well as promoting healthy lifestyle change and behavior modification can positively affect treatment outcomes.
  • What are the evaluation objectives and criteria? Evaluating the patient’s progress is an important part of ensuring success as well as a way of tracking potential compliances. Nurses can use five criteria for evaluating the success of a plan of action for treatment of obesity. These five criteria includes whether the patient has identified risk factors for obesity, undergone proper dietary assessment, practiced an appropriate physical activity, made modifications to lifestyle, and finally reached therapeutic goals.

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