{
  "name": "Obesity & Overweight",
  "slug": "obesity",
  "url": "https://nursingplex.com/care-plans/obesity",
  "category": "Endocrine & Metabolic",
  "summary": "Excess adiposity; behavioral, dietary and activity interventions plus comorbidity screening.",
  "nursing_diagnoses": [
    "Imbalanced nutrition: more than body requirements",
    "Activity intolerance",
    "Disturbed body image"
  ],
  "overview": [
    "Obesity is excess adipose tissue, defined in adults by a BMI of 30 or above, with overweight at 25–29.9. It results from sustained positive energy balance shaped by genetics, environment, medications, endocrine disease, sleep, stress and socioeconomic factors — not simply willpower.",
    "Excess adiposity drives insulin resistance, dyslipidemia, hypertension, obstructive sleep apnea, osteoarthritis, fatty liver, several cancers and reduced mobility. Central (visceral) fat carries greater metabolic risk than peripheral fat.",
    "Nursing care is respectful, weight-inclusive and behavior-focused: realistic goals, sustainable dietary change, activity that the person can maintain, screening for comorbidity, and support for the pharmacologic or surgical options when indicated."
  ],
  "key_facts": [
    {
      "label": "Realistic target",
      "text": "A 5–10% weight loss produces meaningful improvement in blood pressure, glucose and lipids."
    },
    {
      "label": "Waist circumference",
      "text": "Above 40 inches in men or 35 in women indicates high visceral fat risk."
    },
    {
      "label": "Language matters",
      "text": "Use person-first, non-judgmental language and appropriately sized equipment to avoid weight stigma."
    },
    {
      "label": "Surgery threshold",
      "text": "Bariatric surgery is generally considered at BMI 40, or 35 with serious comorbidity."
    }
  ],
  "nursing_priorities": [
    "Assess readiness to change and identify contributing factors.",
    "Screen for and manage comorbidities.",
    "Establish achievable, sustainable nutrition and activity goals.",
    "Address emotional eating, stigma and self-esteem.",
    "Prevent skin, mobility and perioperative complications."
  ],
  "assessment": {
    "subjective": [
      "Reports of eating patterns, portion sizes and emotional triggers",
      "History of previous weight-loss attempts and what happened",
      "Reports of joint pain, breathlessness on exertion or daytime sleepiness",
      "Statements about body image, stigma and motivation"
    ],
    "objective": [
      "BMI, waist circumference and weight trend",
      "Blood pressure, fasting glucose or A1c, lipid panel, liver enzymes",
      "Skin fold and pannus areas for intertrigo or breakdown",
      "Gait, mobility and exercise tolerance",
      "Sleep study results if apnea is suspected"
    ],
    "related_factors": [
      "Energy intake exceeding expenditure over time",
      "Sedentary lifestyle and limited access to safe activity",
      "Genetic and metabolic predisposition",
      "Medications such as antipsychotics, steroids, insulin",
      "Emotional eating, depression, poor sleep and food insecurity"
    ]
  },
  "goals": [
    "The client will lose 5–10% of body weight over the agreed timeframe.",
    "The client will describe and follow an individualized eating and activity plan.",
    "The client will show improved blood pressure, glucose or lipid values.",
    "The client will maintain intact skin in skin-fold areas."
  ],
  "interventions": [
    {
      "title": "Assessment and partnership",
      "points": [
        "Ask permission before discussing weight and use neutral language.",
        "Assess readiness with motivational interviewing rather than advice-giving.",
        "Identify medical contributors: hypothyroidism, Cushing's, medications, sleep apnea.",
        "Set collaborative, specific, achievable goals and review them regularly."
      ]
    },
    {
      "title": "Nutrition and activity",
      "points": [
        "Encourage a food and activity diary to build awareness.",
        "Focus on portion control, vegetables, lean protein and reduced sugar-sweetened drinks rather than fad diets.",
        "Recommend building to 150 minutes of moderate activity weekly, starting with what is tolerable.",
        "Refer to a dietitian and structured programs when available."
      ]
    },
    {
      "title": "Prevent complications",
      "points": [
        "Inspect and dry skin folds; use moisture-wicking textiles and treat intertrigo.",
        "Provide appropriately sized cuffs, chairs, beds and lifting equipment.",
        "Screen for sleep apnea, diabetes and cardiovascular disease.",
        "Prepare and support patients undergoing pharmacotherapy or bariatric surgery, including lifelong vitamin supplementation."
      ]
    }
  ],
  "patient_teaching": [
    "Explain that gradual loss of 1–2 pounds per week is safest and most sustainable.",
    "Teach label reading, portion estimation and meal planning.",
    "Encourage self-weighing weekly and celebrating non-scale improvements.",
    "Discuss relapse as normal and plan strategies for high-risk situations."
  ]
}