NCP Eating Disorders : Obesity

Obesity is defined as an excess accumulation of body fat at least 20% over average desired weight for age, sex, and height or a body mass index (kg/m2) of greater than 27.8 for men and greater than 27.3 for women. Obesity is a chronic condition considered by some to be a disability. The general prognosis for achieving and maintaining weight loss is poor; however, the desire for a healthier lifestyle and reduction of risk factors associated with life-threatening illnesses motivate many people toward diets and weight-loss programs.


Community level unless morbid obesity requires brief inpatient stay


Cerebrovascular accident (CVA)/stroke

Cholecystitis with cholelithiasis

Cirrhosis of the liver

Diabetes mellitus/Diabetic ketoacidosis

Heart failure: chronic

Hypertension: severe

Myocardial infarction

Obesity: surgical interventions (gastric partitioning/gastroplasty, gastric bypass)

Psychosocial aspects of care

Thrombophlebitis: deep vein thrombosis

Patient Assessment Database


May report: Fatigue, constant drowsiness

Inability/lack of desire to be active or engage in regular exercise; sedentary lifestyle

Dyspnea with exertion

May exhibit: Increased heart rate/respirations with activity


May exhibit: Hypertension, edema


May report: History of cultural/lifestyle factors affecting food choices

Weight may/may not be perceived as a problem

Eating relieves unpleasant feelings, e.g., loneliness, frustration, boredom

Perception of body image as undesirable

SOs resistant to weight loss (may sabotage patient’s efforts)


May report: Normal/excessive ingestion of food

Experimentation with numerous types of diets (“yo-yo” dieting) with varied/short-lived results

History of recurrent weight loss and gain

May exhibit: Weight disproportionate to height

Endomorphic body type (soft/round)

Failure to adjust food intake to diminishing requirements (e.g., change in lifestyle from active to sedentary, aging)


May report: Pain/discomfort on weight-bearing joints or spine


May report: Dyspnea

May exhibit: Cyanosis, respiratory distress (Pickwickian syndrome)


May report: Menstrual disturbances, amenorrhea


May report: Problem may be lifelong or related to life event

Family history of obesity

Concomitant health problems may include hypertension, diabetes, gallbladder and cardiovascular disease, hypothyroidism

Discharge plan

DRG projected mean length of inpatient stay: 5.1 days

May require support with therapeutic regimen; home modifications, assistive


Refer to section at end of plan for postdischarge considerations.


Metabolic/endocrine studies: May reveal abnormalities, e.g., hypothyroidism, hypopituitarism, hypogonadism, Cushing’s syndrome (increased insulin levels), hyperglycemia, hyperlipidemia, hyperuricemia, hyperbilirubinemia. It is also suggested that the cause of these disorders may arise from neuroendocrine abnormalities within the hypothalamus, which result in various chemical disturbances.

Anthropometric measurements: Measures fat-to-muscle ratio.


1. Assist patient to identify a workable method of weight control incorporating healthful foods.

2. Promote improved self-concept, including body image, self esteem.

3. Encourage health practices to provide for weight control throughout life.


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.