Measures of body fat
Evidence Statement: Measures of body fat give reasonably equivalent values for following overweight or obese patients during treatment. Evidence Category D.
BMI to assess overweight
RECOMMENDATION: Practitioners should use the BMI to assess overweight and obesity. Body weight alone can be used to follow weight loss and to determine efficacy of therapy. Evidence Category C.
Waist circumference
Evidence Statement: Waist circumference is the most practical anthropometric measurement for assessing a patient’s abdominal fat content before and during weight loss treatment. Computed tomography and magnetic resonance imaging are both more accurate but are impractical for routine clinical use. Evidence Category C.
assess abdominal fat content
RECOMMENDATION: The waist circumference should be used to assess abdominal fat content. Evidence Category C.
classify overweight
RECOMMENDATION: The BMI should be used to classify overweight and obesity and to estimate relative risk for disease compared to normal weight. Evidence Category C
BMI cut points
Evidence Statement: The same BMI cut points can be used to classify the level of overweight and obesity for adult men and adult nonpregnant women, and generally for all racial/ethnic groups. Evidence Category C.
Sex specific cutoffs
Evidence Statement: Sex specific cutoffs for waist circumference can be used to identify increased risk associated with abdominal fat in adults with a BMI in the range of 25 to 34.9 kg/m2. An increase in waist circumference may also be associated with increased risk in persons of normal weight. Evidence Category C.
Waist circumference cutpoints
Waist circumference cutpoints can generally be applied to all adult ethnic or racial groups. On the other hand, if a patient is very short (under 5 feet) or has a BMI above the 25 to 34.9 kg/m2range, waist cutpoints used for the general population may not be applicable. Evidence Category D.
identify increased disease risk
RECOMMENDATION: For adult patients with a BMI of 25 to 34.9 kg/m2, sex specific waist circumference cutoffs should be used in conjunction with BMI to identify increased disease risk. Evidence Category C.
Patient motivation
Evidence Statement: Patient motivation is a key component for success in a weight loss program. Evidence Category D.
well designed programs
Evidence Statement: Overweight and obese patients in well designed programs can achieve a weight loss of as much as 10 percent of baseline weight, a weight loss that can be maintained for a sustained period of time (1 year or longer). Evidence Category A.
motivation to enter weight loss therapy
RECOMMENDATION: Practitioners need to assess the patient’s motivation to enter weight loss therapy; assess the readiness of the patient to implement the plan; and then take appropriate steps to motivate the patient for treatment. Evidence Category D.
The initial goal of weight loss therapy
RECOMMENDATION: The initial goal of weight loss therapy should be to reduce body weight by approximately 10 percent from baseline. With success, further weight loss can be attempted, if indicated through further assessment. Evidence Category A.
rate of 1 to 2 lb/week
Evidence Statement: Weight loss at the rate of 1 to 2 lb/week (calorie deficit of 500 to 1,000 kcal/day) commonly occurs for up to 6 months, at which point weight loss begins to plateau unless a more restrictive regimen is implemented. Evidence Category B.
a period of 6 months
RECOMMENDATION: Weight loss should be about 1 to 2 lb/week for a period of 6 months with the subsequent strategy based on the amount of weight lost. Evidence Category B.