- Disturbed Body Image related to societal views affecting the patient’s sense of self-worth and negative effect on sexual and intimate relationships as evidenced by Verbalization of unhappiness with appearance and Feelings of hopelessness
- Imbalanced Nutrition Related to excess intake of food and Unhealthy food choices as evidenced by Intake of more than daily recommended calories and Obese body mass index
- Overweight related to average daily physical activity is less than recommended and excessive consumption of processed or sugary beverages or food as evidenced by BMI 25 kg/m2 to 29.9 kg/m2 and reported or observed dysfunctional eating patterns/behaviours
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Verbalize and express unhappiness towards his physical body image Objective data: -Fear of ridicule or rejection by others -Preoccupation with losing weight -Feelings of hopelessness -Lack of follow-through with diet and exercise plans -Not participating in activities where weight could be an issue | Disturbed Body Image related to societal views affecting the patient’s sense of self-worth and negative effect on sexual and intimate relationships as evidenced by Verbalization of unhappiness with appearance and Feelings of hopelessness | Patient will verbalize a realistic self-image. Patient will demonstrate an acceptance of their self instead of an idealized image. Patient will be able to recognize health-destructive behaviours and demonstrate a willingness to follow a treatment plan that will promote overall health. Patient will be able to describe, touch, and/or observe the affected body part. Patient will be able to demonstrate social involvement. | 1. Provide positive reinforcement. Remain nonjudgmental and help the patient strive for success. Remind them they can lose weight but are worthy of love and acceptance regardless of their outward appearance. 2. Help set motivational goals. Only the patient can decide they are ready for change and put in the effort. Help them come up with reasons that will keep them on track such as feeling confident in a swimsuit or being comfortable in an intimate relationship. 3. Teach positive reward systems. Instead of treating oneself for weight loss with food, suggest buying newer, better-fitting clothing or a new hairstyle to improve body image. 4. Focus on the patient’s strengths. A patient who is struggling with their physical appearance can be redirected to focus on their value as an individual with unique abilities. This can include intelligence, sense of humor, empathy, and ambition. 5. Encourage counselling. Negative thoughts of oneself can be deep-seated and may even be a result of abuse or years of negative self-talk. This requires the intervention of a mental health professional to unlearn trauma. | Patient verbalized a realistic self-image. Patient demonstrated an acceptance of their self instead of an idealized image. Patient recognized health-destructive behaviours and demonstrate a willingness to follow a treatment plan that will promote overall health. Patient described touch, and/or observe the affected body part. Patient will be able to demonstrate social involvement. |
| Subjective data: Verbalize that unable to maintain bodyweight Objective data: -Intake of more than daily recommended calories -Eating in response to emotions (stress, boredom) -Eating large portions -Obese body mass index | Imbalanced Nutrition Related to excess intake of food and Unhealthy food choices as evidenced by Intake of more than daily recommended calories and Obese body mass index | Patient will maintain weight in desired goal range. Patient will recognize factors that are contributing to being under or overweight. Patient will identify appropriate nutritional needs/requirements. Patient will consume adequate nutrition. Patient will verbalize appropriate management of nutrition at home. | 1. Start with small changes. Losing weight and changing diets isn’t easy and requires new habits. Do not overwhelm the patient with strict diets and food changes. Start with small, realistic goals such as adding in a new vegetable every week and reading food labels. 2. Educate on nutrient requirements. Provide education and written materials to guide the patient in smarter food choices. Obese patients often lack required nutrients so the nurse can educate on reducing sodium, increasing vitamin D and protein, and swapping saturated fats for unsaturated fats. 3. Treat health conditions. Underlying health conditions must be controlled to see weight loss. Ensure patients are on an effective regimen for hypothyroidism or diabetes. Patients with little improvement after adhering to weight loss guidelines may require the use of appetite suppressants. 4. Refer to a dietician. Dieticians assist with goal setting, understanding food labels, meal and recipe planning, portion control, and making better food choices. 5. Weigh only weekly; measure body fat. Patients should not obsess about the number on the scale as it may not correlate to fat loss. Patients may notice a reduction in their waist or hip size. Other tools such as callipers can measure the skinfolds that will show body fat vs. muscle. | Patient maintained weight in desired goal range. Patient recognized factors that are contributing to being under or overweight. Patient identified appropriate nutritional needs/requirements. Patient consumed adequate nutrition. Patient verbalized appropriate management of nutrition at home. |
| Subjective data: Verbalize he wanted to change the eating behaviour Objective data: -Portion sizes larger than recommended -Frequent snacking -High intake of fast food –Sedentary lifestyle as evidenced by BMI 25 kg/m2 to 29.9 kg/m2 Triceps skinfold >15mm in men, >25mm in women -Waist circumference >40 inches in men, >35 inches in women | Overweight related to average daily physical activity is less than recommended and excessive consumption of processed or sugary beverages or food as evidenced by BMI 25 kg/m2 to 29.9 kg/m2 and reported or observed dysfunctional eating patterns/behaviours | Patient will demonstrate two measures to reduce weight. Patient will select appropriate food choices to support weight loss. | 1. Instruct the patient to keep a daily food log. The patient is likely unaware of the amount of food consumed and should begin by logging all food and beverages consumed to obtain a baseline of calories, fat, sodium, and sugar. 2. Instruct on avoiding distractions while eating. Distractions such as watching tv, scrolling on social media, and eating while working, can result in eating too quickly and overconsumption. 3. Help the patient create realistic goals. The nurse can assist the patient in choosing realistic goals. Losing weight is challenging, and not reaching goals can cause the patient to lose motivation. 4. Avoid fast food and restaurant meals. High-fat, high-sodium foods are common in fast food items and restaurant meals. Patients who consume fast foods are two times more likely to develop insulin resistance. | Patient demonstrated two measures to reduce weight. Patient selected appropriate food choices to support weight loss. |