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Overweight and Obesity

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Recommendations Recommendations for Obesity Recommendations ACC/AHA COR ACC/AHA LOE Identifying Patients Who Need to Lose Weight (BMI and Waist Circumference) 1a. Measure height and weight and calculate BMI at annual visits or more frequently. I C 1b. Use the current cutpoints for overweight (BMI 25.0-29.9 kg/m 2 ) and obesity (BMI ≥30 kg/m 2 ) to identify adults who may be at elevated risk of CVD and the current cutpoints for obesity (BMI ≥30 kg/m 2 ) to identify adults who may be at elevated risk of mortality from all causes. I B 1c. Advise overweight and obese adults that the greater the BMI, the greater the risk of CVD, type 2 diabetes, and all- cause mortality. I B 1d. Measure waist circumference at annual visits or more frequently in overweight and obese adults. Advise adults that the greater the waist circumference, the greater the risk of CVD, type 2 diabetes, and all-cause mortality. e cutpoints currently in common use (from either NIH/NHLBI or WHO/IDF) may continue to be used to identify patients who may be at increased risk until further evidence becomes available. IIa B Matching Treatment Benefits With Risk Profiles (Reduction in Body Weight Effect on CVD Risk Factors, Events, Morbidity and Mortality) 2. Counsel overweight and obese adults with CV risk factors (high BP, hyperlipidemia, and hyperglycemia), that lifestyle changes that produce even modest, sustained weight loss of 3%-5% produce clinically meaningful health benefits, and greater weight loss produces greater benefits. a. Sustained weight loss of 3%-5% is likely to result in clinically meaningful reductions in triglycerides, blood glucose, HbA1C, and the risk of developing type 2 diabetes; b. Greater amounts of weight loss will reduce BP, improve LDL-C and HDL-C, and reduce the need for medications to control BP, blood glucose, and lipids as well as further reduce triglycerides and blood glucose. I A

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