Waist circumference determination

At each follow-up visit, compliance with a healthy lifestyle should be determined, as well as measurement of physical parameters, including weight, blood pressure, and heart rate. Waist circumference should be measured intermittently. A complete assessment also would include identification of adverse drug reactions or drug interactions if weight-loss medications have been initiated. 

Determine if history of BMI greater than 25 kg/m 2. If unavailable or BMI unknown, obtain weight, height, and waist circumference. Calculate the BMI. Assess the patient s willingness to lose weight. 

Close monitoring should follow to assess weight, BMI, waist circumference, and presence of complications related to the treatment plan. If weight-loss goals are not attained, determine reasons for failure. 

Others would prefer a simple measurement of waist circumference (WC) to determine weight-related health risk. Stratification for men would be a WC less than 38 inches, from 38 to 42 inches, and more than 42 inches for normal, overweight, and obese. For women it would be a WC less than 33 inches, from 33 to 36 inches, and more than 36 inches. 

Waist circumference (WC) is used to assess abdominal fat content. Excess abdominal fat that is out of proportion to total body fat is considered an independent predictor of risk for obesity-related complications. Waist circumference is determined by measuring the distance around the smallest area below the rib cage and the top of the iliac crest. Interpretation varies with age. Men are considered at risk if the waist circumference is greater than 40 inches women are at risk if the waist circumference is greater than 35 inches. These standards do not apply if the patient is less than 5 feet tall or has a BMI of 35 kg/m or greater. 

Mr. Applebod s brother had a history of hypercholesterolemia and because Mr. Applebod s serum total cholesterol had been significantly elevated (296 mg/dL) at his first visit, his blood lipid profile was determined, his blood glucose level was measured, and a number of other blood tests were ordered. (The blood lipid profile is a test that measures the content of the various triacylglycerol- and cholesterol-containing particles in the blood.) His blood pressure was 162 mm Hg systolic and 98 mm Hg diastolic or 162/98 mm Hg (normal = 140/90 mm Hg or less). His waist circumference was 48 inches (healthy values for men, less than 40 for women, less than 35). 

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