Supporting healthy weight in adults

The causes of overweight and obesity are complex. Nutrition and physical activity are directly and indirectly influenced by a wide range of social, environmental, behavioural, genetic and physiological factors.^[1]  Many patients who present above a healthy weight have likely attempted weight loss previously and assumptions about health and motivation can further contribute to weight stigma.^[2]  It is important to gain consent, and undertake assessments in a non-judgmental, sensitive manner.

BMI and waist circumference should be calculated to inform individual’s chronic disease risk profile. An assessment of clinical, psychosocial and dietary, physical activity and sleep behaviours should be conducted in conjunction with weight assessments to determine overall health risk.^[3] 

BMI ranges.^[4] 

There are some exceptions – the healthy weight BMI range is generally:

• lower for people of Asian background
• higher for people of Polynesian background
• higher for older people
• higher for elite athletes with higher levels of lean body tissue
• higher for pregnant women.

Advise, assist, and empower your patients.

All individuals should be advised of the importance of positive health behaviours for overall health including chronic disease prevention. . When an individual is identified as at risk, or overweight or obese with health risks identified treatment and support should be implemented. Individuals should be advised that positive changes to health behaviours and modest amounts of weight loss can improve their health.

Behaviour change support should acknowledge and seek to understand individual circumstances and barriers to inform patient-centered and sustainable strategies. 1 Consideration needs to be given to the interaction of eating and physical activity patterns (e.g. being physically active but binge eating regularly) and factors that influence an individual’s capacity to follow health advice.1

Where changes are required, you can work with individuals to create SMART goals which are achievable and sustainable, and which are more likely to become habits.

Healthy eating:

The Healthy Eating for Adults resource outlines the amount of food and drinks adults are recommended to consume each day, along with tips and information

Physical Activity

The Australian Make Your Move resource for adults 18-64 years  includes recommendations for incorporating physical activity and minimising sedentary behaviour.

Further resources below can be used to educate and advise individuals to adopt healthy behaviour changes that will help them work towards achieving their health goals:

When supporting individuals with health behaviours and weight management, it is important to arrange follow-up appointments to continue to measure and monitor progress and reflect on support required. Consider whether the individual may benefit from referral to lifestyle intervention programs, or requires support from an allied health professional (psychologist, dietitian, exercise physiologist).

Refer to specialist services if indicated: e.g: severe BMI classification and/or critical or complex comorbidities

Up-to-date information about the assessment and management of a range of conditions can be found on HealthPathways. HealthPathways is delivered across Queensland thanks to the support of Clinical Excellence Queensland, and you can find your local HealthPathways website here.

Programs and resources listed below may help facilitate health behaviour change for individuals, or provide additional support or management where appropriate:

Health professionals are recommended to upskill in best-practice prevention, treatment, and management of individuals with overweight or obesity to continue to deliver care with empathy, confidence and success.

Diabetes WA have developed a comprehensive online weight management training for health professionals. The 6 1-hour modules focus on different aspects of weight management, including causes and treatments, from both a patient and health professional perspective. Each module is allocated 1 CPD hour in the RACGP 2023-25 program.  Access “Conversations about weight” here.

Further resources to upskill in prevention, treatment and management of overweight and obesity can be found below:

Healthy eating:

The Australian Dietary Guidelines resource summarises the key recommendations and the underlying evidence supporting food, diet and health relationships.

Physical Activity

The Australian Physical Activity and exercise guidelines for adults includes recommendations for amount and type of activity.

Further clinical guidelines which may assist clinicians supporting the prevention, early intervention and management of overweight and obesity in adulthood are included below: