Adult Weight Management (AWM) Classification of Overweight and Obesity
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
AWM: BMI-Classification of Overweight and Obesity
Body mass index (BMI) and waist circumference should be used to classify overweight and obesity, estimate risk for disease, and to identify treatment options. BMI and waist circumference are highly correlated to obesity or fat mass and risk of other diseases (NHLBI report).
AWM: Body Weight-Classification of Overweight and Obesity
Body weight and waist circumference should be used to determine the effectiveness of therapy in the reassessment. BMI and waist circumference are highly correlated to obesity or fat mass (NHLBI report).
Risks/Harms of Implementing This Recommendation
If a patient is very short (under 5 feet) or has a BMI above the 25 to 34.9 range, waist cutpoints used for the general population may not be applicable. In addition, BMI may overestimate body fat in athletes and others who have a muscular build and those with edema. BMI may underestimate body fat in older persons and others who have lost muscle mass.
Conditions of Application
Recommendation applies to adult men and adult nonpregnant women, and generally for all racial/ethnic groups.
Potential Costs Associated with Application
- The same BMI cutpoints 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. NHLBI Evidence Category C.
- 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. NHLBI Evidence Category C.
- The waist circumference should be used to assess abdominal fat content. NHLBI Evidence Category C.
- Waist circumference cutpoints can generally be applied to all 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 range, waist cutpoints used for the general population may not be applicable. NHLBI Evidence Category D.
Recommendation Strength Rationale
- NHLBI Evidence Categories of C and D
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
The Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report, NIH Publication No. 98-4083, September 1998, produced by the National Heart, Lung, and Blood Institute in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases.
To access the pdf of the NHLBI Clinical Guidelines click here: http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/index.htm