Acham Leon

Nutrition Therapy 1 Case Study 3

Michelle Elkadi
October 27, 2015

Describe the stages of readiness for change, and identify where you think she falls on
this continuum.

The stages of readiness for change begin with pre-contemplation where the client doesnt
even consider change and would need some information to raise awareness. Next is
contemplation, this is where the client has awareness and a reason to change, and also stay the
same but not willing to take the action at the time. Then preparation is where the client is ready
to make changes and needs help to move forward or else relapse will happen. Action is where
client performs change through change. Maintenance is sustaining behaviors to prevent relapse.
If a relapse occurs then its important to make changes again, reestablish behaviors.1 I think the
client is in preparation stage, where she wants to make changes, but lacks the support and
information to move forward and make the necessary changes.

2. Calculate her BMI. How would you interpret it? (2 points) How does her waist
circumference measurement add to your assessment? (2 points)

The clients BMI is 28.7 and the formula I used was (weight in lbs. x703)/(height in
inches)2. She is classified as overweight by her BMI, but her waist circumference is indicative of
metabolic syndrome and weight problems.

3. What does her history of giving birth to heavier than average babies suggest? (5 points)
It suggests that she was overweight during and/or before her pregnancy, which has been

known to lead to overweight babies, and developing gestational diabetes.1

4. Does she meet the criteria for this syndrome according to the National Cholesterol
Education Panels Adult Treatment Panel III? (3 points) How is metabolic syndrome
treated with diet and physical activity? (3 points)
The client meets all five criteria to be diagnosed with metabolic syndrome. She can treat
her metabolic syndrome by increasing exercises, reducing body fat, having food choices that are
low in fat, high in fiber, and meet all DRIs for nutritional needs.2

5. What can you do to help her become motivated from within herself to change her diet
and exercise behaviors? (5 points)
The client can become motivated by keeping her childrens health in mind; when eating
and picking out meal. She has stated that she wants to set a good example; so inspiring her to
keep on healthy guidelines will not only help her but also help her children.
6. Assuming she becomes ready to take action, identify some initial steps that she might
take to improve her diet. (5 points)
Creating an appropriate meal plan for breakfast, lunch and dinner that are family
centered. The client can also prepare healthy snacks for her and her children. By planning
healthy snacks that are prepared ahead of time should help control impulsive urges to eat fatty
and fast foods. It would also help if the client can exercise 30 minutes a day with a walk.1

7. What is the role of physical activity in weight loss and weight maintenance? (3

points) How do aerobic activity, strength training, and stretching all contribute to optimal
weight management? (3 points)
Calories are burned and fat stores are used for energy for the body during physical activity. This
can ensue weight loss, circulation and cardiac strength. Strength training also helps with weight
management .1

8. What methods would you suggest she could use for self-monitoring? (5 points)
Setting goals to eliminate certain bad foods and incorporate healthy foods. Food diary is
an efficient way to self-monitor and monitoring weight.

9. Make suggestions for handling family meals, special occasions, and holidays. (5 points)
Do theme style meals, where the family can choose from a variety of healthy options,
which can encourage the kids to experiment with meals, as well as allowing left overs for snacks
and quicker meals. She could also gather ideas from her family, which promotes family
participation in meals, and can give the kids health ideas for food.1

10. Write a PES statement based on her initial presentation. How would you monitor and
evaluate the effect of your interventions? (5 points
Patient has metabolic syndrome related to her being overweight as evidenced by her 38
waist circumference, and 189 mg/dL triglycerides.2

References
1. Mahan L, Escott-Stump S. Krause's Food & Nutrition Therapy. 12th ed. St.
Louis, Mo.: Saunders/Elsevier; 2007.
2. Blackboard. Case Studies. 2015. Available at:
https://blackboard.unf.edu/bbcswebdav/pid-3275227-dt-content-rid24773228_1/courses/2015FALL.DIE3213.80710.01/Case%20Studies
%20%285%29.pdf. Accessed October 24, 2015.