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Prevention of chronic disease

Overweight

Guidelines for preventive activities in general practice
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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

Obesity-related complications: Identifying risks

Table 7.2.1

Obesity-related complications: Identifying risks
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Overweight and obesity: Assessment and preventive interventions

Table 7.2.2

Overweight and obesity: Assessment and preventive interventions
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Nutrition: Healthy weight: Body mass index (kg/m2 )

Table 7.2.3

Nutrition: Healthy weight: Body mass index (kg/m2 ) 82
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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

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