weight lose

body mass index & waist circumference

In spite of body mass index (BMI) is a perferable tool to assess obesity, it cannot assess the abdominal fat in normal or overweight personel. Abdominal fat is associated with a greater health risk than peripheral fat (fat in the gluteal-femoral region).
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supported by research
The evaluation of waist circumference to assess the risks associated with obesity or overweight is supported by research.
The measurement of waist-to-hip ratio provides no advantage over waist circumference alone.
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with BMIs ≥ 35 no need to measure waist circumference
It is not necessary to measure waist circumference in individuals with BMIs ≥ 35 kg/m2 since it adds little to the predictive power of the disease risk classification of BMI.
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waist circumferences greater than 40 inches
Men who have waist circumferences greater than 40 inches, and women who have waist circumferences greater than 35 inches, are at higher risk of diabetes, dyslipidemia, hypertension, and cardiovascular disease because of excess abdominal fat.
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BMI is a direct calculation
BMI is a direct calculation based on height and weight, regardless of gender. Waist circumference is the most practical tool a clinician can use to evaluate a patient’s abdominal fat before and during weight loss treatment
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BMI limitations
BMI has some limitations. For example, BMI over estimates body fat in persons who are very muscular, and it can under estimate body fat in persons who have lost muscle mass (e.g., many elderly).
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The risk varies among individuals
It should be noted that the relationship between BMI and disease risk varies among individuals and among different populations. Some individuals with mild obesity may have multiple risk factors; others with more severe obesity may have fewer risk factors.
Our notes

BMI & weight control

BMI variation

older persons often have lost muscle mass; thus, they have more fat for a given BMI than younger persons. Women may have more body fat for a given BMI than men, whereas patients with clinical edema may have less fat for a given BMI compared with those without edema. Nevertheless, these circumstances do not markedly influence the validity of BMI for classifying individuals into broad categories of overweight and obesity in order to monitor the weight status of individuals in clinical settings

Clinical judgment

Clinical judgment must be used in interpreting BMI in situations that may affect its accuracy as an indicator of total body fat. Examples of these situations include the presence of edema, high muscularity, muscle wasting, and individuals who are limited in stature.
The relationship between BMI and body fat content varies somewhat with age, gender, and possibly ethnicity because of differences in the composition of lean tissue, sitting height, and hydration state.

Exclusion From Weight Loss Therapy Patients

Exclusion From Weight Loss Therapy Patients
are most pregnant or lactating women,
persons with a serious uncontrolled psychiatric illness such as a major depression,
and patients who have a variety of serious illnesses and for whom caloric restriction might exacer- bate the illness.

Patients with active substance abuse and those with a history of anorexia nervosa or bulimia nervosa should be referred for specialized care

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