Millions of people in England and Wales with a long-term health condition should have their body mass index (BMI) checked regularly to prevent diabetes and heart disease, an NHS watchdog is recommending.
Anyone found to be overweight should talk to sensitive, non-judgmental doctors and nurses about how they can lead a healthier life and stop their excess pounds causing them problems.
The checks should lead to more people being referred to weight management services for help overhauling their diet and lifestyles or being prescribed weight loss drugs.
The National Institute for Health and Care Excellence (Nice), which advises the NHS on which treatments represent value for money, hopes its recommendations will help curb obesity.
People with conditions such as diabetes, lung problems and heart failure should have their BMI and waist-to-height ratio assessed and recorded at least once a year, Nice said on Tuesday in draft guidance which is set to be published as a final document in August.
The watchdog has published a list of conditions – including fat in the blood, obstructive sleep apnoea and rheumatoid arthritis – where sufferers would have one or both checks. If the NHS changes its practice to implement Nice’s new approach, that would see 13 million patients checked.
Under the plan those whose BMI is at least 35, classed as very obese, would have their BMI measured when they visit a GP surgery or attend a hospital appointment for any reason.
Those with any of the long-term conditions outlined by Nice whose BMI is under 35 would have both their BMI and waist-to-height ratio monitored.
“These simple annual measurements create opportunities for early intervention and conversations about long-term health and wellbeing.
“By identifying trends before they become problems, clinical practitioners can help people prevent more serious health complications down the line,” said Prof Jonathan Benger, Nice’s deputy chief executive and chief medical officer.
“Annual monitoring of BMI and waist-to-height ratio is a powerful tool to help prevent problems developing, such as the onset of diabetes, heart disease or other obesity-related conditions.”
Almost two-thirds of the 13 million people are meant to have their BMI recorded every year already when they visit a GP. But that sometimes does not happen or is not recorded in their medical record, Nice said.
After someone is identified as carrying excess pounds “healthcare professionals should seek permission in a sensitive, non-judgmental way before discussing weight, because people may then be more receptive to offers of support that would have a positive impact on their health”, the draft guidance states.
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Doctors, nurses and other health professionals who undertake the checks should “approach conversations in a sensitive, non-judgmental way and respect the person’s choice (and that of their family or carer, if relevant) if they do not wish to discuss their weight”, it adds.
Prof Kamila Hawthorne, the chair of the Royal College of General Practitioners, said the BMI checks were a good example of preventive medicine and would help patients to understand their weight.
“GPs, and other members of our teams, are trained to have sensitive but frank conversations around weight and nutrition with our patients. There is no ‘one size fits all’ approach to weight management and GPs hear first-hand how hard it can be for some of our patients to maintain a healthy weight,” she said.
Dell Stanford, a senior dietitian at the British Heart Foundation, said monitoring the millions of people with heart conditions would help them to access better care and reduce their risk of developing further health problems linked to being overweight.
It would be better to improve people’s diets by forcing food firms to make their products healthier than waiting for people to become overweight in the first place, said Sonia Pombo, the head of impact and research at Action on Salt.
