Dieting and physical exercise are the mainstays of treatment for obesity. Moreover, it is important to improve diet quality by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fiber. To supplement this, or in case of failure, anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption. In severe cases, surgery is performed or an intragastric balloon is placed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.
Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century.Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world
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
- Fatigue, constant drowsiness
- Inability/lack of desire to be active or engage in regular exercise; sedentary lifestyle
- Dyspnea with exertion
Increased heart rate/respirations with activity
- 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)
- 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
- 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)
Pain/discomfort on weight-bearing joints or spine
Cyanosis, respiratory distress (Pickwickian syndrome)
Menstrual disturbances, amenorrhea
- 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.
- Assist patient to identify a workable method of weight control incorporating healthful foods.
- Promote improved self-concept, including body image, self esteem.
- Encourage health practices to provide for weight control throughout life.
- Healthy patterns for eating and weight control identified.
- Weight loss toward desired goal established.
- Positive perception of self verbalized.
- Plans developed for future weight control.
- Plan in place to meet needs after discharge.