Obesity Screening Recommendations and Emerging Policies

 

BMI

Obesity class

Disease risksa relative to normal weight and waist circumference

Men

Women

Underweight

< 18.5
   
Normal

18.5–24.9
   
Overweight

25.0–29.9
 
Increased

High

Obese

30.0–34.9

I

High

Very high

35–39.9

II

Very high

Very high

40 and up

III

Extremely high

Extremely high


Adapted from: National Institutes of Health [10]

BMI body mass index

aDisease risk for type 2 diabetes, hypertension, and cardiovascular disease (CVD)



Guidelines for the screening and evaluation of overweight and obesity have been published by a number of organizations including the National Heart, Lung, and Blood Institute (NHLBI) [4], the World Health Organization (WHO) [8], and the United States Preventive Services Task Force [2, 5, 9] (Table 13.2). NHLBI [10] recommends screening adults for obesity with BMI and waist circumference and risk factor assessment. Subsequent intervention is then based upon overall risk assessment [4]. The United States Preventive Services Task Force (USPSTF) recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese (BMI >30 kg/m2) adults. The Canadian Task Force on Preventive Health Care recommends measuring BMI and waist circumference in all adults. The American College of Obstetricians and Gynecologists recommends measuring BMI in all adult women as part of routine gynecologic and well woman visits [3]. Overweight or obese women should then be counseled about the healthy eating and increasing physical activity.


Table 13.2
Summary of screening recommendations from expert committees




























Expert committee

Recommendation

United States Preventive Services Task Force

Screening all adults for obesity

Clinicians should offer or refer patients with a body mass index of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions

NHLBI

The NIH recommends screening adults for obesity with BMI, waist circumference and risk factor assessment. Subsequent intervention is then based upon overall risk assessment

Canadian Task Force

Measure body mass index and waist circumference in all adults and adolescents to determine the degree and distribution of body fat

Measure blood pressure, heart rate, fasting glucose level, and lipid profile (total cholesterol, triglycerides, high-density and low-density lipoprotein cholesterol levels)

Consider appropriate pharmacotherapy or referral for bariatric surgery, or both

American Congress of Obstetricians and Gynecologists

Measure BMI in all adult women presenting for any clinical visit

Jun 8, 2017 | Posted by in GYNECOLOGY | Comments Off on Obesity Screening Recommendations and Emerging Policies

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