Nursing care plan eating disorders obesity

I. Pathophysiology
a. A chronic excess accumulation of body fat, at least 20% over
average desired weight for age, sex, and height, or a body
mass index (BMI) greater than 30 for persons of either sex
b. Negatively impacts all body systems and increases risk of
multiple physical and psychological pathologies, including
hypertension, heart disease, diabetes, arthritis, depression
and anxiety disorders, difficulty maintaining personal relationships,
prejudice and discrimination, and limited access
to public conveniences
II. Etiology
a. Causes are multiple, complex, and cannot be attributed
simply to a disorder of willpower or the result of insufficient
exercise
i. Variations in metabolism, body fat distribution, and
appetite regulation can be attributed to genetic factors
(Farooqi & O’Rahilly, 2007).
ii. Physiological factors
1. Lesions in the hypothalamus—appetite and satiety centers
2. Hypothyroidism—may interfere with basal metabolism
3. Diabetes mellitus—decreased insulin production or
utilization
4. Cushing’s disease—increased cortisone production
iii. Environmental influences, behavioral and societal
issues: includes availability of high-fat, calorie-dense
conve-nience foods, large portions, and sedentary
lifestyle
iv. Psychosocial influences: possibility of unresolved
dependency needs with individual fixed in the oral stage
of pychosexual development, with food believed to be a
coping mechanism for dealing with life’s problems
b. Most likely influenced by multiple factors as demonstrated
by the Transactional Model of Stress/Adaptation
(Townsend, 2006)
III. Statistics
a. Morbidity: Approximately 34%, over 72 million of
Americans, are termed as being obese in 2006 (Centers for
Disease Control and Prevention [CDC], 2007).
b. Mortality: An estimated 112,000 premature deaths are
associated with obesity (BMI less than or equal to 30)
annually (CDC, 2005a).
c. Cost: In 2000, more than $117 billion was spent to manage
obesity in the United States (CDC, 2005a); approximately
$52 billion are direct costs of healthcare, with $33 billion
spent on weight-loss products and services annually
(Uwaifo & Arioglu, 2006).

Care Setting
Community level unless morbid obesity requires brief
inpatient stay.

Related Concerns
Cerebrovascular accident (CVA)/stroke,
Cholecystitis with cholelithiasis,
Cirrhosis of the liver,
Diabetes mellitus/diabetic ketoacidosis,
Heart failure: chronic,
Hypertension: severe,
Myocardial infarction,
Obesity: bariatric surgery—gastric partitioning/gastroplasty,
gastric bypass,
Psychosocial aspects of care,
Thrombophlebitis: deep vein thrombosis,

Nursing Priorities
1. Assist client to identify a workable method of weight
control, incorporating healthful foods and activity.
2. Promote improved self-concept, including body image
and self esteem.
3. Encourage health practices to provide for weight control
throughout life.

Discharge Goals
1. Healthy patterns for eating and weight control identified.
2. Weight loss toward desired goal established.
3. Positive perception of self verbalized.
4. Plans developed for future weight control.
5. Plan in place to meet needs after discharge.

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