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
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 |

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