Height: 5 ft 4 in

Weight: 234 lbs

BMI: 40.2

Registered Dietitian

Leah Kostos, RD

Insurances: Aetna,Anthem,Blue Cross Blue Shield,Cigna,United Healthcare

Diagnosis and Treatment Plan

Changes / challenges since last visit

The patient states that the number on the scale and her measurements are fluctuating. However, she states that her clothes are fitting better- jeans not as tight. She will be shopping for new clothes soon as her June month is very busy with events.

Last weigh in (5/30/24): 234.5 lbs

This weekend: Musical

Next weekend: Wedding

Nutrition Diagnosis (PES statement)

Inadequate fiber intake related to food- and nutrition-related knowledge deficit as evidenced by patient food recall showing insufficient intake of fiber when compared to recommended amounts (25 g/day for women)

Morbid obesity related to energy intake in excess as evidenced by high BMI of 40.25 and patient reports of large portions of food at meals.

Nutrition Intervention


Total energy estimated needs: 1500-1700 calories per day (MSJ x AF 1.2)

Total protein estimated needs: 93-106 grams per day (AMDR 25% total calories)

Total fluid estimated needs: 121 ounces or about 15 cups per day (1/2 body weight in ounces)

Other recommendations: eat regularly and routinely to stimulate your metabolism, drink adequate fluids to help manage appetite and healthy weight, pair a protein or healthy fat and carbohydrate source for snacks to help regulate blood sugar.

Action Plan: As stated below in goals.

Education Materials Provided:

Nutrition Counseling Utilized: Motivational Interviewing.


  1. The patient will track her food on Lose It.
  2. The patient will exercise 4-5 days per week (2 circuit trainings with personal trainer, 2 zumba).
  3. The patient will aim to hit 10 grams of fiber per day.
  4. The patient will aim to hit her macro intake of 40-30-30% by swapping out high fat options for low fat options and swapping evening out high fat options with protein (for example, adding greek yogurt to peanut butter to make it balanced and whipped).
  5. The patient will implement exercise snacks daily (1 exercise every couple of hours).

Monitoring & Evaluation

Next appointment date: 6/19/24 at 4pm

Topics Discussed

High Cholesterol,Weight Loss

Appointment History

Number of Sessions: 12

Last Updated: Jun 01, 2024