NHS ordered to ensure doctors record tens of millions of patients body mass index so they can identify if their weight is putting them at risk
Tens of millions of people will now have their BMI checked and recorded by the NHS annually. The regulator has announced that everyone in England and Wales living with long-term conditions such as diabetes and heart disease should have their body mass index recorded at least once a year.
The National Institute for Health and Care Excellence (NICE) said an additional waist-to-height ratio measurement will be taken for people with a BMI below 35 – to flag those not carrying lots of extra weight but who are still out of shape. The draft guidance for the NHS is intended to help medics intervene with support to stop more serious or life-threatening conditions developing as a result of them being overweight or obese.
It does not provide a definitive list of long-term conditions but suggests medics focus on patients with COPD, diabetes, dyslipidaemia – abnormal levels of fats in the blood, heart failure, obstructive sleep apnoea, peripheral arterial disease, polycystic ovary syndrome, rheumatoid arthritis, schizophrenia, bipolar disorder, stroke or transient ischemic attack. It also advises anyone with a learning disability should also have their BMI taken annually.
Professor Jonathan Benger, chief medical officer at NICE, said: “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.”
Annual NHS physical health checks should already take place for people with long term conditions but NICE said the recording of someone’s BMI and waist-to-height ratio is not always taking place or being added to their health record.
The draft guidance also states GPs should support people with learning difficulties to get access to weight management support where necessary. It highlights that continued support should be provided to any patients who have had such a behavioural intervention so that lifestyle changes can be maintained and they do not pile the pounds back on.
The guidance stresses that “wraparound care focusing on diet, nutrition and physical activity” should be provided for anyone prescribed weight loss injections. These can lead to sudden loss of fat and muscle mass but without sustained lifestyle changes, which often require ongoing support – patients can put the fat back on.
Prof Benger added: “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. Once implemented, these proposed quality standards could significantly improve health outcomes for people with long-term conditions by ensuring consistent, timely support for weight management across all healthcare settings.”
The draft guidance is open for public consultation until April 15 before the final NHS guidance is expected to be published in August.
Dr Rebecca Payne, GP and chair of NICE’s quality standards advisory committee, said: “We want to hear from healthcare professionals and commissioners during the consultation period to understand whether the proposals we have made can be implemented in the NHS.
“NICE must focus on what matters most and in areas where it can make the biggest difference. We expect these changes to demonstrate the impact we are having on the lives of people with weight related conditions.”