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CONTINUING PROFESSIONAL DEVELOPMENT
BY ANNA EZZY
Weight management is an increasingly important public health priority in
Australia. In 2011–12, 63% of Australian adults were overweight or obese,
a significant increase from ~56% in 1995.
Recent estimates suggest
that by 2025, 83% of females and 75% of males aged over 20 years will
be overweight or obese.3 The Australian Government considers obesity a
National Health Priority Area due to the significant burden of illness and
injury it creates in the community.
Classifying overweight and
obesity in adults
Overweight and obesity is widely
classified using body mass index
The World Health Organization
thresholds for BMI classify people with
a BMI ≥25 kg/m2 as overweight, and
those with a BMI ≥30 kg/m2 as obese.
Thresholds are the same for men and
women, however, interpretation of BMI
may be complicated in populations that
display variation in muscle and fat mass.
In particular, adjustment of thresholds
may be required for different ethnic
groups. A lower threshold for BMI should
be considered for people of Asian, and
Aboriginal and Torres Strait Islander
descent, while for Maori and other Pacific
Islander people, adjustment upwards may
In addition to BMI, waist circumference
(WC) provides a good indication of total
body fat, and risk of obesity-related
comorbidities. Evidence-based guidelines
recommend using WC in addition to
BMI to assess the risk of obesity-related
comorbidities. For women, the risk is
increased when waist circumference is
≥80 cm, and high when ≥88 cm. For men,
these measurements are ≥94 cm and
≥102 cm respectively. However thresholds
differ depending on ethnicity.
For more information see National
Health and Medical Research Council
(NHMRC) Clinical Practice Guidelines for the
management of overweight and obesity in
adults, adolescents and children in Australia.
Burden of disease and the
benefits of weight loss
Overweight and obesity is responsible
for ~7.5% of the attributable burden
of disease in Australia, third only
behind tobacco and hypertension.
Of particular concern is the association
with cardiovascular disease and diabetes.8
People who are obese are five times as
likely as those who were of normal weight
or underweight to have high triglycerides,
more than twice as likely to have lower
than normal levels of HDL cholesterol and
seven times more likely to have diabetes.9
Other obesity-related comorbidities
include metabolic syndrome, sleep
apnoea, arthritis, gastro-oesophageal
reflux disease (GORD), polycystic ovary
syndrome (PCOS), stress incontinence, and
certain types of cancer.
The risk of morbidity and mortality as a
result of obesity-related comorbidities
increases significantly when BMI
Approximately 70% of
people with a BMI >30 kg/m2 have at least
one established comorbidity, resulting
in medical costs that are about 30%
greater than people of healthy weight.
Having a BMI of 30–35 kg/m2 reduced life
expectancy by 2–4 years, whilst people
with a BMI 40–45 kg/m2 can expect to
live 8–10 years less than people within a
healthy weight range.
Many obesity-related conditions are
preventable, and several are at least
partially reversible through weight loss.
Weight loss of 5–10% of total body
weight can have significant health
benefits, including improved control of
dyslipidaemia, hypertension and type 2
1,6 However greater weight loss
Anna Ezzy is the Resource Development Manager
working out of the PSA Victorian office.
After reading this article the pharmacist should be
Describe the health benefits of weight
Discuss methods to achieve successful weight
loss and management
Identify approaches for weight loss that are
Competency standards (2010) addressed: 1.3,
6.1, 6.3 .
Accreditation number: CAP150101B
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