Age 0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-79 >80
Body mass index (BMI) and waist circumference should be measured every two years and recorded in the medical record (A). On its own, BMI may be misleading, especially in older people and muscular individuals, and classifications may need to be adjusted for some ethnic groups9. Waist circumference is a stronger predictor of CVD and diabetes than weight alone76,77.
Patients who are overweight or obese should be offered individual lifestyle education and skills training (A)9 . Restrictive dieting is not recommended for children and most adolescents who have not completed their growth spurt9. A modest loss of 5–10% of starting body weight in adults who are overweight is sufficient to achieve some health benefits.9,78
Consider and offer adult patients a range of treatment options. Individual education and simple behavioural interventions are appropriate for some patients, while behavioural approaches may be more appropriate for those with disordered eating patterns. Behaviour change techniques include goal setting, self-monitoring of behaviour and progress, stimulus control (eg recognising and avoiding triggers that prompt unplanned eating), cognitive restructuring (modifying unhelpful thoughts or thinking patterns) or problem-solving, and relapse prevention and management.9
Telephone coaching has been demonstrated to be comparable with face-to-face techniques and is available in most states.83,84
For adolescents and children, lifestyle programs should focus on parents, carers and families. Advise that weight maintenance is an acceptable approach in most situations for children who are overweight or obese. Recommend lifestyle changes, including reducing energy intake and sedentary behaviour, and increasing physical activity based on current Australian dietary and physical activity guidelines.9
For more information, refer to The Royal Australian College of General Practitioners’ (RACGP) Smoking, Nutrition, Alcohol and Physical activity (SNAP): A population health guide to behavioural risk82 and National Health and Medical Reserach Council’s (NHMRC) Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia9
- National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Canberra: NHMRC, 2013.
- National Aboriginal Community Controlled Health Organisation and The Royal Australian College of General Practitioners. National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people. 2nd edn. East Melbourne, Vic: The Royal Australian College of General Practitioners, 2012.
- National Vascular Disease Prevention Alliance. Guidelines for the assessment of absolute cardiovascular disease risk. Melbourne: National Heart Foundation of Australia: 2009
- Schulze MB, Heidemann C, Schienkiewitz A, Bergmann MM, Hoffmann K, Boeing H. Comparison of anthropometric characteristics in predicting the incidence of type 2 diabetes in the EPIC-Potsdam Study. Diabetes Care 2006;29(8):1921–23.
- US Preventive Services Task Force. Final recommendation statement: Obesity in adults: Screening and management. Washington, DC USPSTF, 2014. Available at www.uspreventiveservicestaskforce.org/ Page/Document/RecommendationStatementFinal/ obesity-in-adults-screening-and-management [Accessed 23 March 2016].
- LeBlanc ES, O’Connor E, Whitlock EP, Patnode CD, Kapka T. Effectiveness of primary care–relevant treatments for obesity in adults: A systematic evidence review for the US Preventive Services Task Force. Ann Int Med 2011;155(7):434–47.
- Sargen G, Pilotto L, Baur L. Components of primary care interventions to treat childhood overweight and obesity: A systematic review of effect. Obes Rev 2011;12:e219–e35.
- US Preventive Services Task Force. Screening for and management of obesity in adults. Ann Intern Med 2012;157(5):373–78.
- The Royal Australian College of General Practitioners. Smoking, nutrition, alcohol, physical activity (SNAP): A population health guide to behavioural risk factors in general practice. 2nd edn. East Melbourne, Vic: RACGP, 2015.
- Dennis SM, Harris M, Lloyd J, Powell Davies G, Faruqi N, Zwar N. Do people with existing chronic conditions benefit from telephone coaching? A rapid review. Aust Health Rev 2013;37(3):381–88.
- O’Hara BJ, Phongsavan P, Venugopal K, et al. Effectiveness of Australia’s Get healthy information and coaching service(R): Translational research with population wide impact. Prev Med 2012 Oct;55(4):292–98.