Adults

Supporting health behaviours in adulthood

Supporting healthy weight in adults

Health professionals in primary health care are the first line of intervention for preventative health and have an important role in supporting patients to achieve and maintain healthy behaviours and a healthy weight.[1] Early adulthood usually coincides with a reduction in physical activity, changes to diet and alcohol consumption.[1] 

Regular monitoring of health behaviours, waist circumference and weight can help to identify if an adult is at risk of chronic disease and overweight and obesity.

Ask and Assess

  • Assess BMI and waist circumference.  Review trend over time. 
  • Ask about planned pregnancies.   
  • Assess modifiable behaviours (fruit, vegetables and alcohol intake, take away/eating out frequency, sedentary behaviour, physical activity, sleep). 
  • If clinical concern exists, conduct clinical, psychological and socio-environmental assessment.

Advise and Assist

  • Discuss identified risk factors, focusing on those that are modifiable. Share resources as appropriate.  
  • Use positive, health-focused language that minimises judgment.
  • Co-design an action plan with the individual, focusing on health behaviours that are achievable and sustainable.
  • Advise adults living with overweight or obesity or chronic disease that a weight reduction of 5-10% improves health.

Arrange and Ask Again

  • Arrange a follow-up appointment to monitor progress.
  • Refer at risk or non-complex adults to allied health/healthy lifestyle programs Multi-component, high intensity behaviour interventions are most effective.
  • Modest weight reduction of 5-10% in those with overweight and obesity at risk of or living with chronic disease results in significant health benefits. Treatment goals remain focused on behaviour change and health goals. 
  • Refer to specialist services if indicated: e.g: severe obesity and/or complex comorbidities.

Resource Library

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] 

BMI (adults) Classification
Less than 18.5 Underweight
18.5 to 24.9 Healthy weight
25 to 29.9 Overweight but not obese
30 to 34.9 Obese class I
35 to 39.9 Obese class II
40 or more Obese class III

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.
Resource
Author
ASK
Ask: starting the conversation about weight
WA Shape
ASSESS
Taking patient centered measurements
WA Shape
BMI and waist
DoH
Measuring waist circumference (video)
British Heart Foundation
Healthy Eating Quiz for Adults
University of Newcastle
BMI calculator heart foundation
Heart Foundation
Potential Eating Disorder assessment tool
EDQ
ESSA screening tool: Adult pre-exercise screening system
ESSA
Physical Activity Stage of Change
Exercise is medicine

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:

Resource
Author
NUTRITION
Healthy eating for adults
NHMRC
Healthy Meals and menu planning
Qld Government, NEMO
Convenience meals
Baker Institute
Healthy snacks
Baker Institute
Eating Out
Baker Institute
Nutrition Label reading
Baker Institute
Supermarket shopping guide
Baker Institute
Portion Plate Guide
Baker Institute
PHYSICAL ACTIVITY
Make your move
DoH
Activity Planner for adults
DoH
ABORIGINAL AND TORRES STRAIT ISLANDER RESOURCES
Aboriginal and Torres Strait Islander Guide to healthy eating
DoH
Good Quick Tukka recipes
Deadly Choices

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:

Resource
Author
HEALTHY HABITS
My health for life
Diabetes Australia
Logan Healthy Living
UQ Healthcare
RACGP Healthy Habits App
RACGP
Work it out
IUIH
SMoCC service (Self Management of Chronic Conditions).
Queensland Health
NUTRITION
Dietitian (Dietitians Australia)
Dietitians Australia
PHYSICAL ACTIVITY
10,000 Steps
CQUniversity
Heart foundation walking
Heart Foundation
Exercise Professional (ESSA)
ESSA
MENTAL HEALTH
GP Eating Disorder Plan (EDP)
InsideOut
Helplines and Online Counselling Services
AIFS
ASSESSMENT AND MANAGEMENT
Health pathways
Queensland Government

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:

Resource
Format
Author
ADULTHOOD
Online weight management training for health professionals
eLearning
WAPHA / Diabetes WA
The Australian Obesity Management Algorithm: A simple tool to guide the management of obesity in Primary Care
Journal Article
Markovic T, Proietto JC, Dixon JB., et al.
EATING DISORDERS
Understanding Eating Disorders
PDF
EDQ
Eating Disorders Core Skills - eLearning for GPs
eLearning
National EDC
Eating disorders - a professional resource for GPs
PDF
National EDC
GENERAL SKILLS
5As: Ask, assess, advise, assist and arrange
PDF
RACGP
5As of Obesity Management
Video
RACGP
SCOPE E-learning for obesity
E-learning
World Obesity
Brief interventions for a healthy lifestyle
E-learning
Insight - Qhealth
Brief Interventions: Nutrition and Physical Activity
E-learning
Insight - Qhealth
Motivational Interviewing RACGP
Journal Article
RACGP
Motivational Interviewing
Webpage and Videos
Healthify He Puna Waira
Weight stigma and obesity
Video
Yale University
Shift: A guide for media and communications professionals
PDF
Government of Western Australia
EQUITY
Working with people with a disability
PDF
Metro South

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:

Resource
Author
NUTRITION
Australian Dietary Guidelines
NHMRC
PHYSICAL ACTIVITY
Physical Activity and exercise guidelines for Adults
DoH
Physical activity recommendations for people with disability or chronic conditions
DoH
EATING DISORDERS
Clinical Guidelines for Therapeutic Interventions in Eating Disorders
EDQ
Management of eating disorders for people with higher weight
NEDC
PREVENTION
Guidelines for preventive activities in general practice
RACGP
WEIGHT MANAGEMENT
Clinical Practice Guidelines for the management of overweight and obesity
DOH
WEIGHT INCLUSIVITY
Quick Guide: Safe, inclusive and accessible environments for people with obesity
The Obesity Collective

References

  1. National Health and Medical Research Council (2013) Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: National Health and Medical Research Council.
  2. National eating disorders Collaboration, NEDC (2022). Management of eating disorders for people with a higher weigh: clinical practice guideline.
  3. Smoking, nutrition, alcohol, physical activity (SNAP): A population health guide to behavioural risk factors in general practice, 2nd edn. Melbourne: The Royal Australian College of General Practitioners 2015.
  4. Body Mass Index (BMI) and Waist measurement. Australian Government: Department of Health and Aged Care. https://www.health.gov.au/topics/overweight-and-obesity/bmi-and-waist 2021

Clinicians Hub is brought to you by Health and Wellbeing Queensland in partnership with Allied Health Profession’s Office of Queensland, Clinical Excellence Queensland.

Last updated 5 January 2024