Assessment Of Overweight And Obesity (Page 2 of 2) in pdf

BACKGROUND INFORMATION FOR THE HEALTH PROFESSIONAL

TREATMENT ALGORITHM*

1. The person’s risk status should be assessed by determining the degree of overweight or

obesity based on BMI. the degree of abdominal obesity based on waist circumference,

and the presence of concomitant risk factors or co-morbidities.

Patient Encounter

2. An increased waist circumference is independently associated with increased health risk

including people with a BMI less than 25kg/m².

Hx of 25 BMI?

3. If the BMI is above 35kg/m² the waist circumference does not add significantly to the risk

estimation.

Yes

4. Waist circumference cut-off points can generally be applied to all adult ethnic groups

BMI

measured in past

unless the person is very short (less than 150cm).

2 years?

5. The relationship between BMI and health risk weakens with increasing age, especially over

75 years. This is partly explained by confounding factors (such as occult diseases, selected

survival and smoking).

• Measure weight,

height and waist

6. At any given percentage of body fat, BMI is one or two units higher in Polynesians than in

circumference

• Calculate BMI

New Zealand Europeans and these differences increase with increasing BMI.

7. Asian ethnicity is associated with a smaller body frame and therefore BMI cut-offs should be

adjusted downwards, however, equivalent levels have not been determined.

BMI 30 OR

{BMI 25 to 29.9 OR

BMI ³ 25 OR

Yes

waist circumference

Assess risk factors

>88cm (F) >102cm (M)}

>88cm (F)

AND

>102cm (M)

Clinician and patient

2 risk factors

devise goals and

treatment strategy

for weight loss

Instructions for Measuring Waist Circumference

and risk factor control

Yes

To define the level at which waist circumference is

Hx BMI 25?

measured, a bony landmark is first located. The

Does patient

want to lose

measuring tape is placed in a horizontal plane

Progress

weight?

being made/goal

around the abdomen at a level just above the

Yes

achieved?

Brief reinforcement/

Advise to maintain

uppermost lateral border of the iliac crest. The plane

educate on weight

weight/address

of the tape is parallel to the floor and the tape is

management

other risk factors

snugg, but does not compress the skin. The

measurement is made at a normal minimal

Maintenance counseling:

Assess reasons for

expiration.

• Dietary therapy

failure to lose

Periodic Weight Check

• Behaviour therapy

weight

• Physical activity

Examination

ADVANTAGES OF WEIGHT LOSS

Treatment

•

Lowering of elevated blood pressure in overweight and obese persons.

•

Lowering of total cholesterol, LDL-cholesterol, and triglyceride, raising of low

HDL-cholesterol levels in overweight and obese persons with dyslipidaemia.

* This algorithm applies only to the assessment for overweight and obesity and subsequent

•

Lowering of elevated blood glucose levels in overweight and obese persons

decisions based on that assessment. It does not reflect any initial overall assessment for other

with type 2 diabetes.

conditions and diseases that the clinician may wish to do.

Assessment Of Overweight And Obesity Page 2

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