![]() ![]() Therefore, the relative contributions of different components of abdominal fat to overall risk remain to be determined with certainty. Several studies suggest that the visceral fat component of abdominal fat is the most strongly correlated with risk factors other studies, however, indicate that the subcutaneous component is the most highly correlated with insulin resistance. Abdominal fat is described as having three compartments: visceral, retroperitoneal, and subcutaneous. ![]() Rationale: Fat located in the abdominal region is associated with greater health risks than that in peripheral regions, e.g., the gluteal-femoral area. Computed tomography and magnetic resonance imaging are both more accurate but are impractical for routine clinical use. ![]() Waist circumference is the most practical anthropometric measurement for assessing a patient's abdominal fat content before and during weight loss treatment. A patient should be weighed with shoes off and clad only in a light robe or undergarments. × 703 Ī simple BMI chart is provided in Appendix V. To estimate BMI from pounds and inches use: For example, BMI overestimates body fat in persons who are very muscular and can underestimate body fat in persons who have lost muscle mass (e.g., the elderly). The limitations of BMI as a measure of total body fat, nonetheless, must be recognized. BMI is a direct calculation based on height and weight, regardless of gender. BMI is a practical indicator of the severity of obesity, and it can be calculated from existing tables. Rationale: The panel concentrated on tools available in the office, i.e., weight, height and the BMI. Body weight alone can be used to follow weight loss and to determine efficacy of therapy. ![]() Practitioners should use the BMI to assess overweight and obesity. However, simply measuring body weight is a practical approach to follow weight changes. BMI provides an acceptable approximation for assessment of total body fat for the majority of patients. BMI is recommended as a practical approach for the clinical setting. The weight tables also are based on mortality outcomes and do not necessarily predict morbidity. In addition, separate tables are required for men and women. Ideal body weight tables were developed primarily from white, higher socioeconomic status populations and have not been documented to accurately reflect body fat content in the public at large. It has an advantage over percent above ideal weight (e.g., based on the Metropolitan Life Insurance Tables). BMI provides a more accurate measure of total body fat than relying on weight alone. No studies have been published to compare the effectiveness of different measures for evaluating changes in body fat during weight reduction. No trial data exist to indicate that one measure of fatness is better than any other for following overweight and obese patients during treatment. Thus, bioelectrical impedance offers no significant advantage over BMI in the clinical management of patients. Although bioelectrical impedance devices are becoming more readily available, they lose accuracy in severely obese persons and are of limited usefulness for tracking changes in total body fat in persons losing weight. Rationale: Even though accurate methods to assess body fat exist, measuring body fat content by these techniques is often expensive and is not readily available clinically. Measures of body fat give reasonably equivalent values for following overweight or obese patients during treatment. ![]()
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