Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: LIFESTYLE| 5-7

BODY WEIGHT ASSESSMENT

An initial assessment of a patient with diabetes should include calculation of body mass index (BMI) as well as a measurement of waist circumference (WC) to assess for abdominal obesity (11). The Canadian Guidelines for Body Weight Classification in Adults uses BMI and WC as indicators of health risk (12). Metabolic comorbidities are highly correlated to increasing BMI and WC (13,14). The classification system is not intended for use with those under 18 years of age or with pregnant and lactating women. As well, it may underestimate or overestimate health risks in specific groups, such as young adults who have not reached full growth, adults who have a very lean body build, highly muscular adults, adults over 65 years of age and certain ethnic and racial groups.

Body Mass Index BMI is calculated using the following equation: weight (kg) [height (m)] 2

BMI is not a direct measure of body fat, but it is the most widely investigated and most useful available indicator of health risk associated with under- and overweight. However, BMI does not account for differences due to frame size or fat distribution; it does not reveal how much of a patient’s weight is fat, nor does it consider where the fat is located. A BMI in the range of 18.5 to 24.9 kg/m 2 has been set as the boundary for healthy weight, reflecting the reality that being either underweight or overweight impairs health status (see Table 1). A BMI of 30 kg/m 2 and above is defined as obese.