What we cover:
Setting weight loss goals
BMI and waist circumference are important measures for evaluating obesity-related health risks.1 There are several things that you as a healthcare provider can do in order to make this experience as comfortable for your patient as possible.
When weighing your patient:
- Ensure weighing scales are in an area which offer privacy.
- Ensure weighing scales can measure greater than 200 kg.
- Refrain from announcing your patient’s weight in a non-private area.
1. Assess BMI
Diagnosing obesity begins with assessing your patient’s BMI – this is a simple measurement of your patient’s weight (kg) divided by the square of their height in metres.2
The World Health Organisation propose a BMI-centric classification system to guide population level and clinical decision-making strategies.2
|
Classification |
BMI |
|---|---|
Obesity | ≥30 |
Obesity class I | ≥30 and <35 |
Obesity class II | ≥35 and <40 |
Obesity class III | ≥40 |
BMI may not be as accurate in highly muscular people. For people of
Asian ethnicity, practitioners should consider lowering the treatment
threshold in the presence of central obesity. The Clinical Guidelines
for Weight Management in New Zealand Adults (2017) reported no
evidence for using different thresholds for Māori and Pacific Peoples.3
2. Measure waist circumference
Use waist circumference to provide supporting information, especially if you suspect excess intra-abdominal fat in people who are overweight but not obese.3 Below is a guide on how you can make this a more comfortable experience for your patient:1
- Hand the person one end of the measuring tape and ask them to hold it at their belly button. Request they make one turn so that the tape wraps around their waist.
- Grasp both ends of the tape and adjust it to ensure the tape is at the level of the upper hip bones and record their waist circumference.
| Waist circumference cut-offs to identify increased relative risk for the development of obesity-related complications3* | |
|---|---|
Men | > 102cm |
Women | > 88cm |
*Consider lowering the threshold for people of Asian ethnicity. 3
3. Start the conversation
Below are some examples of how your weight management conversation could start:
"If we can review your previous test results for a moment, I think it may be beneficial to discuss how improving your health and losing weight would benefit some of these results in the future."
"Carrying excess weight can be a cause of some of your health concerns. Can we discuss how losing weight can improve your health?"
Explain that obesity is not your patient’s fault. When discussing weight management with your patient, it is important you help them understand that body weight is influenced by many different factors, including genetics, environment and hormones, and that’s why losing weight and maintaining weight loss may be challenging for people living with obesity.1,4
4. Take weight history
During your weight management discussion, consider taking your patient’s weight history to understand any potential triggers for their weight gain, their weight loss attempts to date and to discuss any challenges they encountered.
Below are some examples of questions, which could help to initiate
your weight history discussion with your patient:
"Do you feel as if your weight has been an issue in the past? For how long?"
"Tell me about your efforts with trying to lose weight in the past."
5. Set realistic and attainable goals
Once you have a good understanding of your patient’s weight journey so far, you can progress to discussing and setting goals together. Below are some examples of questions, which could support the conversation on goal setting with your patient:
"What are some reasonable goals you could set regarding your weight?"
"What kind of changes would you be willing to start with?"
Start by eliciting what your patient’s goals are. By doing this, you can help them to determine realistic and achievable targets. Consider the following:
- Short-term goals
- Long-term goals
Next, together with your patient, explore how they will be able to achieve these goals. The steps should be measurable and build on each other over time. The goals and the steps taken to achieve these goals should be mutually agreed with your patient.
Lastly, set realistic dates for when your patient will aim to achieve both their short- and long-term goals, and importantly, set expectations that weight management is a long-term process.5
References
- National Institutes of Health. Clinical Guidance on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available at: https://www.ncbi.nlm.nih.gov/books/NBK2003/ (Accessed August 2024).
- World Health Organisation. Obesity: Preventing and Managing the Global Epidemic. Available at: https://iris.who.int/handle/10665/42330 (Accessed August 2024).
- New Zealand Ministry of Health. Clinical Guidelines for Weight Management in New Zealand Adults. 2017. Available at: https://www.health.govt.nz/system/files/documents/publications/clinical-guidelines-for-weight-management-in-new-zealand-adultsv2.pdf (Accessed August 2024).
- Wright SM, Aronne LJ. Abdominal Imaging. 2012;37:730–732.
- Vallis M, et al. Canadian Family Physician. 2013;59:27–31.
Related articles
You are now leaving Rethink Obesity®
The site you are entering is not the property of, nor managed by, Novo Nordisk. Novo Nordisk assumes no responsibility for the content of sites not managed by Novo Nordisk. Furthermore, Novo Nordisk is not responsible for, nor does it have control over, the privacy policies of these sites.
The information on this website is intended for healthcare professionals. If you are a healthcare professional and have not received the password, please e-mail Novo Nordisk Medical Information at nzlccc@novonordisk.com