Logic Diagram for a Program Based on Prioritized Need

Logic diagram for a program based on prioritized need
Patient
Encounter
(See Box 1)
Measure weight,
height; calculate
BMI
(See Box 2)
Yes
BMI ≥25
Assess and treat risk
factors for CVD and
obesity-related
comorbidities
(See Box 4)
Assess weight and
lifestyle histories
(See Box 5)
Advise to
avoid weight gain;
address and treat
other risk factors
(See Box 7)
No, insufficient risk
No, not yet ready
No
BMI 18.5-24.9
Measure weight
and calculate BMI
annually or more
frequently
(See Box 17) Yes
Evaluation
Treatment
BMI 25-29.9 (overweight)
or 30-34.9 (class I obese)
or 35-39.9 (class II obese)
or ≥40 (class III obese)
(See Box 3)
Assess need to
lose weight:
BMI ≥30 or BMI 25-29.9
with risk factor(s)
(See Box 6)
Assess readiness to
make lifestyle changes
to achieve weight loss
(See Box 8)
Yes, ready
Follow-up and
weight loss
maintenance
(See Box 15)
Determine weight loss
and health goals and
intervention strategies
(See Box 9)
Comprehensive lifestyle
intervention alone or
with adjunctive therapies
(BMI ≥30 or ≥27 with
comorbidity)
(See Box 10)†
High-intensity
comprehensive
lifestyle
intervention
(See Box 11a)
Alternative delivery
of lifestyle
intervention
(See Box 11b)
BMI ≥30 or BMI ≥27 with
comorbidity—option for adding
pharmacotherapy as an adjunct to
comprehensive lifestyle
intervention
(See Box 12)†
BMI ≥40 or BMI ≥35 with comorbidity.
Offer referral to an experienced
bariatric surgeon for consultation and
evaluation as an adjunct to
comprehensive lifestyle intervention
(See Box 13)
Yes
Yes
Continue intensive
medical management of
CVD risk factors and
obesity-related
conditions; weight
management options
(See Box 19)
Intensive behavioral
treatment (See Box 10);
reassess and address
medical or other
contributory factors;
consider adding or
reevaluating obesity
pharmacotherapy
(See Box 12), and/or
refer to an experienced
bariatric surgeon
(See Box 13)
No
No
Yes, ready
Weight loss ≥5%
and sufficient improvement
in health targets
(See Box 14)
Weight
loss ≥5% and sufficient
improvement
in health targets
(See Box 18)

Management of overweight and obesity in
adults.
1. Overweight refers to an increase in body weight relative to height
compared to certain criteria for acceptable or required weight.
Obesity is an excessive amount of fat in a body associated with lean body
mass.
3. Overweight is a body mass index of 25 to 29.9 kg / m2.
4. Obesity was defined as the total fat excess recorded by BMI > 30 kg / m2.
5. The prevalence of obesity and overweight increased somewhat from 37.8%
for men to 39.4% & from 23.6% for women to 24.7%.
6. However, during the same period, the prevalence of the obesity increased
from 9.4% in men to 19.9%, and in women from 20.1% to 25.9% (Heber, 2013).

PART 1: Resources
Recommend other
resources (for example,
self-help and support
groups)
Liaison with
community projects
(e.g., work, school,
church)
National Audit Office
data
Weight Control
Information Network
Information sheets
and brochures
Audiovisual and
educational materials