Synopsis
Assess adiposity and its health effects without stigma, identify treatable drivers and complications, and build a sustainable multicomponent plan around the person's priorities and circumstances.
- Ask permission to discuss weight, use the person's preferred language and offer a private, accessible weighing environment with suitable calibrated equipment.
- BMI is a screening measure, not a direct measure of individual health, muscle, fat distribution, disability, ethnicity, pregnancy or lived experience.
- For adults with BMI below 35, waist-to-height ratio can add central-adiposity information; a waist less than half height is a simple population message.
Key red flags
Loud snoring, witnessed apnoeas, morning headache, unrefreshing sleep and daytime somnolence suggest obstructive sleep apnoea; awake hypoxaemia, hypercapnia or somnolence can indicate obesity hypoventilation.
Investigation priorities
Provide a reproducible baseline for population risk and treatment eligibility.
Management branches
Weight or central adiposity may be contributing to current health concerns.
- Ask permission, agree neutral language, provide privacy and accessible equipment, and establish what the person hopes will improve rather than imposing a target.
- Measure BMI and central adiposity where useful, then assess medical complications, medicines, sleep, mental health, eating pattern, mobility and socioeconomic constraints.
Severe comorbidity, safeguarding, disordered eating or complex disability limits routine management.