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Adult Weight Management

AWM: Scope of Guideline (2022)

Guideline Scope Characteristics

Disease/Condition(s)

This EBPG is meant to inform clinical decisions for dietitians by providing MNT interventions for adults (≥18 years of age) with overweight or obesity (body mass index (BMI) ≥25 kg/m2 or as defined for specific adult populations), including those with cardiometabolic disease such as T2DM or CVD. This EBPG does not address overweight and obesity management for pediatric clients (<18 years of age). This EBPG is not intended for clients with eating disorders or diagnoses such as cancer, chronic kidney disease and other conditions for which weight loss may be contraindicated. This EBPG does not describe nutrition screening or assessment methods or monitoring and evaluation in depth, and more detailed recommendations for these stages of the Nutrition Care Process can be found in the Academy’s 2014 AWM EBPG.1 Comparisons of the topics addressed in  2014 and current EBPGs are described in the Recomemndation Comparison Table.

Though dietitians may help to address barriers based on Social Determinants of Health (SDoH), such as by providing resources for food assistance to address food insecurity, this EBPG specifically focuses on behavioral lifestyle interventions for individual clients. This EBPG does not address post-metabolic and bariatric surgery nutrition care in detail, but this topic has been examined in a prior Academy systematic review.2 Recommendations related to weight loss and calorie reduction are intended for clients for whom weight loss is “appropriate for and desired by” the client based upon shared decision-making. In this context, the term “appropriate for” indicates that the client is overweight or obese and does not have a condition for which weight loss is contraindicated. In this EBPG, cardiometabolic outcomes refer to blood pressure (BP), fasting blood glucose (FBG) and waist circumference (WC). All recommendations should be interpreted through the lens of clinical judgement and client values and all recommendations should be individualized to each client’s needs and preferences.3
 
The health questions this EBPG addresses are: In adults ≥18 years of age with overweight or obesity (BMI ≥25 kg/m2 or as defined for specific adult populations), what is the effect of MNT interventions, including specific components of interventions, provided by dietitians on cardiometabolic outcomes, quality of life and body weight outcomes? 

Guideline Category

Counseling, Management, Intervention

Clinical Specialty

Nutrition

Intended Users

This guideline is primarily intended for RDNs working with adults (≥18 years of age) with overweight or obesity.

Guideline Objective(s)

To provide evidence-based recommendations for dietitians providing behavior change-based nutrition interventions for adults (≥18 years of age) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client.

Target Population

Adults (≥18 years of age) with overweight or obesity (body mass index (BMI) ≥25 kg/m2 or as defined for specific adult populations), including those with cardiometabolic disease such as type 2 diabetes or cardiovascular disease. 

Target Population Description

Adults (≥18 years of age) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client.

Proceed to Statement of Intent Return to AWM Home