PES Statements for Obesity - Dietitian Direction

Introduction to PES Statements

PES statements are structured sentences used by dietitians to communicate the nutrition diagnosis of a patient. PES statements are part of the Nutrition Care Process (NCP), which provides dietitians a framework for providing nutritional services.

Writing a PES Statement

PES statements are written as follows:

[Problem/nutrition diagnosis] related to [Etiology], as evidenced by [Signs/symptoms].

Looking for more information on PES statements before diving in? Check out these other blog posts:

What is a PES Statement?

Nutrition Diagnosis: Definition & Examples

Nutrition Care Process Steps

Potential Nutrition Diagnoses for Obesity

The complete list of nutrition diagnostic terminology is found in the Electronic Nutrition Care Process Terminology (eNCPT). Here are some nutrition diagnoses that may pertain to patients with obesity:

Excessive energy intake
Predicted excessive energy intake
Excessive oral intake
Overweight/obesity
Unintended weight gain
Food and nutrition related knowledge deficit
Not ready for nutrition related behavior change
Limited adherence to nutrition related recommendations
Physical inactivity

PES Statements for Obesity Examples

Excessive energy intake related to intake of calorically dense foods as evidenced by regular consumption of pizza, juice and whole milk, BMI of 37.1.

Excessive energy intake related to food and nutrition related knowledge deficit as evidenced by no previous nutrition education, daily intake of sweetened beverages.

Excessive oral intake related to cultural and social norms of the family as evidenced by eating until uncomfortably full, having multiple meat servings at dinner.

Obesity Class III related to physical inactivity as evidenced by an average of 2000 steps per day, BMI of 47.2.

Unintended weight gain related to increased appetite caused by multiple rounds of steroids as evidenced by 20 lb weight gain over the course of 6 months.

Food and nutrition related knowledge deficit related to limited previous nutrition education as evidenced by 50 lb weight gain in the last 5 years, low perceived severity of risk.

Not ready for nutrition related behavior change related to belief that nutrition changes are not possible with current time constraints as evidenced by patient stating he does not have enough time to eat healthy.

Limited adherence to nutrition-related recommendations related to cognitive deficit as evidenced by patient not being able to teach-back the plate method.

Quick Tips for Writing the Perfect Obesity PES Statement

Use information gathered in the assessment to determine the nutrition problem
The nutrition diagnosis should ideally be resolved, or at least improved, through a nutrition intervention provided by the dietitian
PES statements should be clear and concise

Conclusion

Obesity is a complex disease that can have a wide variety of nutrition problems and etiologies. There is no “right” or “wrong” PES statement, but make sure yours is specific to the patient using the data you collected in your assessment.

Note that the 2023 edition of the Nutrition Care Process Terminology (eNCP) is used, which is the most current version at the time of this article being published.