Healthy Weight Management | Texas Health and Human Services

Maintaining a healthy weight is important to achieve optimum quality of life, maintain physical functions and reduce medical complications.

Healthy body weight is defined as a body mass index (BMI) of 18.5 to 24.9 kg/m2. Overweight is defined as a BMI between 25 and 29.9 kg/m2, and obesity is defined as a BMI >30 kg/m2.

Significant weight loss is defined as a loss of more than 5 percent of body weight during a 30-day period or more than 10 percent of body weight during a 180-day period. It is an important predictor of morbidity and mortality. Weight loss of more than 10 percent of body weight during a 30-day period is considered to represent protein-energy malnutrition. Contributing factors to weight loss must be identified to implement appropriate care.

Significant weight gain occurs when BMI increases from overweight (25-29.9 kg/m2) to obesity (>30 kg/m2). In addition to identifying contributing factors, the person's readiness to change their food intake and change their amount of physical activity must be determined. An individualized plan for weight management includes both caloric reduction and physical activity.

Resources Created By DADS

Best Practice Prevention And Management of Unintended Weight Loss (PDF) provides evidence-based best-practice guidelines for addressing unintended weight loss in the long-term care setting.
Best Practice Prevention Management of Unintended Weight Gain (PDF) provides evidence-based best-practice guidelines for addressing unintended weight gain in the long-term care setting.
Best Practice Recommendations for Weight Loss at the End of Life (PDF) provides evidence-based best practice guidelines for addressing weight loss at the end of life in the long-term care setting.
Nutrition Care: Preventing Unintended Weight Loss in LTC Facilities (PDF) provides evidence-based best-practice guidelines for preventing unintended weight loss in the long-term care setting.
Healthy Weight Management (PDF) provides evidence-based best practice guidelines for managing both unintended weight loss and weight gain in the long-term care setting.
Liberalizing Diets and the Dining Experience (PDF) provides evidence-based best-practice guidelines for preventing weight loss and for enhancing dining service.
Care Plan – Unintended Weight Loss – Dependence (PDF) provides evidence-based best-practice guidelines for managing unintended weight loss in the long-term care setting.
Care Plan – Unintended Weight Loss – Depression and Diet (PDF) provides evidence-based best-practice guidelines for managing unintended weight loss in the long-term care setting.
Care Plan – Unintended Weight Gain – Obesity and Sleep Apnea (PDF) provides evidence-based best-practice guidelines for managing unintended weight gain in the long-term care setting.
Care Plan – Weight Loss at the End of Life (PDF) provides evidence-based best-practice guidelines for managing weight loss at the end of life in the long-term care setting.
Best Practice Management of Intended Weight Gain handout (PDF) provides evidence-based best-practice guidelines for managing intended weight gain.
Best Practice Management of Unintended Weight Gain handout (PDF) provides evidence-based best-practice guidelines for managing unintended weight gain.
Best Practice Management of Intended Weight Loss handout (PDF) provides evidence-based best-practice guidelines for managing intended weight loss.
Best Practice Management of Unintended Weight Loss handout (PDF format) provides evidence-based best-practice guidelines for managing unintended weight loss.
Best Practice Dining/Meal Service Techniques (PDF format) provides evidence-based best-practice guidelines to improve dining and meal service techniques.

Resources from Other Organizations

The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obese Adults (PDF) provides the basic tools needed to appropriately assess and manage people who are overweight or obese.
Mini Nutritional Assessment is a screening and assessment tool that can help identify people age 65 and older who are malnourished or at risk of malnutrition.
AMDA – The Society for Post-Acute Care and Long-term Care Medicine has an extensive selection of educational, informational and problem-solving tools for practitioners and medical directors in long-term care settings. AMDA’s tools and products are developed through its Clinical Practice Committee. Individual titles may be selected. Anyone can order a product, with members getting a significant discount.
Academy of Nutrition and Dietetics (formerly the American Dietetic Association) provides trustworthy, science-based food and nutrition information for the public and health professional. Topics for the public include Healthy Weight, Eat Right Nutrition Tips, Good Nutrition Reading List and a body mass index (BMI) calculator. Resources for health professional include medical nutrition therapy and position papers such as: Weight Management; Individualized Nutrition Approaches for Older Adults in Health Care Communities; and Ethical and Legal Issues in Nutrition, Hydration and Feeding.
Weight-control Information Network (WIN) provides up-to-date, science-based information on weight control, obesity, physical activity and related nutritional issues.
Texas Diabetes Council Toolkit is for Texas practitioners and diabetes educators working with patients who have diabetes.
Interactive Dietary Reference Intake (DRI) for Healthcare Professionals can be used to calculate daily nutrient recommendations based on the Dietary Reference Intakes (DRIs). lndividual requirements may be higher or lower than the DRIs.
New Dining Practice Standards are nationally agreed upon new food and dining standards of practice support individualized care and self-directed living versus traditional diagnosis-focused treatment for people living in nursing homes.

Bibliography

Curtis JP, Selter JG, et al. Body Mass Index and Outcomes in Patients With Heart Failure. Archives of Internal Medicine 2005; 165:55-61.
American Medical Directors Association. Altered Nutritional Status in the Long-Term Care Setting Clinical Practice Guideline. Columbia, MD: AMDA 2010.
American Dietetic Association. Position of the American Dietetic Association: Liberalization of the Diet Prescription Improves Quality of Life for Older Adults in Long-Term Care. Journal of the American Dietetic Association 2005; 105 (12): 1955-1965.
American Dietetic Association. Position Paper of the American Dietetic Association: Nutrition Across the Spectrum of Aging. Journal of the American Dietetic Association 2005; 105 (4): 616-633.
Flicker L, McCaul KA, Hankey GJ, et al. Body Mass Index and Survival in Men and Women Aged 70-75. Journal of American Geriatric Society. 2010; 58 (2): 234-241.
American Dietetic Association. Position of the American Dietetic Association: Weight Management. Journal of the American Dietetic Association 2009; 109 (2): 330-346.
American Dietetic Association. Position of the American Dietetic Association: Individualized Nutrition Approaches for Older Adults in Health Care Communities. Journal of the American Dietetic Association 2001; 110 (10): 1549-1553.
American Dietetic Association. Practice Paper of the American Dietetic Association: Individualized Nutrition Approaches for Older Adults in Health Care Communities. Journal of the American Dietetic Association 2010; 110 (10): 1554-1563.
VanSickle C. Adiposity Associated With Longer Survival in Older Adults. Medscape Medical News May 18, 2010. www.medscape.com
Barclay L. Overweight Elderly Have Similar Mortality to Normal-Weight Elderly. Medscape Medical News January 28, 2010. www.medscape.com
Bradway C, Miller E, Heivly A, Fleshner I. Continence Care for Obese Nursing Home Residents. Medscape Medical News May 18, 2010. www.medscape.com
Grabowski DC, Campbell CM, Ellis JE. Obesity and Mortality in Elderly Nursing Home Residents. The Journals of Gerontological 2005; 60 (9): 1184-1189.
Kushner RF, Blatner DJ. Risk Assessment of the Overweight and Obese Patient. Journal of the American Dietetic Association 2005; 105 (5): S53-S62.
Kyrou I, Tsigos C. Obesity in the Elderly Diabetic Patient. American Diabetes Association 2009
Donini LM, Chumlea WC, Vellas B, et al. International Symposium "Obesity in the Elderly". Rome, 2006
Houston DK, Nicklas BJ, Zizza CA. Weighty Concerns: The Growing Prevalence of Obesity among Older Adults. Journal of the American Dietetic Association 2009; 109 (11): 1886-1895.
Villareal DT, Apovian CM, Kushner RF, Klein S. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. American Journal of Clinical Nutrition 2005; 82: 923-34.
Salihu HM, Bonnema SM, Alio AP. Obesity: What is an elderly population growing into? Maturitas 63 (2009) 7-12.
Barclay L. Waist Circumference Linked to All-Cause Mortality in Older Adults. Medscape Medical News August 9, 2010. www.medscape.com
Kivimaki MG, Batty D, et al. Association between common mental disorder and obesity over the adult life course. The British Journal of Psychiatry 2009; 195: 149-155.
Witham MD, Avenell A. Interventions to Achieve Long-term Weight Loss in Obese Older People: A Systematic Review and Meta-analysis. Age and Ageing. 2010; 39 (2): 176-184.
Sommers, AR. Obesity Among Older Adults. Congressional Research Service Report for Congress. February 6, 2008
Kennedy RL, Chokkalingham K, Srinivasan R. Obesity in the elderly: who should we be treating, and why, and how? Ageing: biology and nutrition 2004; 1363-1950
Flood M, Newman AM. Obesity in Older Adults. Journal of Gerontological Nursing 2007: 19-34
Lang IA, Llewellyn DJ, et al. Obesity Physical Function, and Mortality in Older Adults. Journal of the American Geriatrics Society 2008; 56 (8): 1474-78.
Chernoff R. Dietary Management of Older Subjects with Obesity. Clinics in Geriatric Medicine 2005; (21) 725-733.
Bales CW, Buhr G. Is Obesity Bad for Older Persons? A Systematic Review of the Pros and Cons of Weight Reduction in Later Life. Journal of American Medical Association June 2008; 302-312.
Zamboni M, et al. Health consequences of obesity in the elderly: a review of four unresolved questions. International Journal of Obesity 2005; (29) 1011-1029.
National Heart, Lung, and Blood Institute National Institutes of Health. The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NIH Publication 00-4084; October 2000.