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Obesity - Management
How should I first broach the issue of weight with someone?
- Healthcare professionals should use clinical judgement when deciding whether to measure a person's height and weight, but opportunities include when a person registers at the practice and at consultations for conditions related to obesity (e.g. type 2 diabetes and cardiovascular disease).
- Approach the subject of weight carefully because people who are overweight or obese may be sensitive about discussing it, or feel that their presenting problem is being overlooked.
- Initiate a conversation about the person's weight if they appear to be overweight or obese and there are no reasons why this should not be discussed.
- For example, offer to discuss their height and weight measurements, and if their body mass index is in the overweight or obese category, discuss the possible health implications of this.
- Explain why excess weight can be problematic in terms of comorbidities and the chance of developing complications.
- Discuss why gaining more weight may increase risks to health.
- Make the person aware of the benefits of modest weight loss with regard to comorbidities and disease risk, particularly if they are obese (see Table 1).
Clarification / Additional information
Table 1. The benefits of a 10 kg weight loss in a person with obesity.
| Benefit |
|---|
Mortality | > 20% reduction in total mortality > 30% reduction in deaths related to diabetes > 40% reduction in obesity-related cancer deaths |
Blood pressure (in people who are hypertensive) | Reduction in systolic blood pressure of 10 mmHg Reduction in diastolic blood pressure of 20 mmHg |
Diabetes (in people who are newly diagnosed) | Reduction in fasting glucose of 50% |
Lipids | Reduction in total cholesterol of 10% Reduction of low density lipoprotein (LDL) of 15% Reduction in triglycerides of 30% Increase of high density lipoprotein (HDL) of 8% |
Other benefits | Improved lung function, insulin sensitivity, and ovarian function Reduced back pain, joint pain, breathlessness, and sleep apnoea |
|
Basis for recommendation
- This recommendation is based on the Department of Health Care Pathway for the management of overweight and obesity [DH, 2006a].
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