Fwd: NHLBI Press Release - Federal Obesity Clinical Guidelines (fwd)

[Laura Larsson]

Friends:

A posting from a non-suscriber for your information.

Regards,

Laura
larsson at u.washington.edu
listowner: PHNUTR-L, PHNURSES, PNWHEALTH, HSR-L +
http://weber.u.washington.edu/~hserv/hshome.html
http://weber.u.washington.edu/~phnutr/nutrhome.html

---------- Forwarded message ----------
Date: Thu, 4 Jun 98 10:55:11 -0700
From: "Krueger, Karen E." <kek0303 at hub.doh.wa.gov>
To: larsson at u.washington.edu
Subject: Fwd: NHLBI Press Release - Federal Obesity Clinical Guidelines

Please post on the Public Health Nurses and Public Health Nutritionist's 
listservers.  Thanks.
__________________________

Karen Krueger, RN, MN, MBA
Heart Health Program Manager/
Public Health Nurse Consultant
WA State Dept. of Health
P.O. Box 47835
Olympia, WA 98504-7835
NOTE NEW PHONE:  360/236-3611 after 2/23/98
FAX 360/664-2619  (Unchanged)
Internet  kek0303 at hub.doh.wa.gov
************************* Forwarded Message *************************

>>> Keith Hewitt 06/04/98 09:44am >>>



FOR IMMEDIATE RELEASE		
June 3, 1998					

STATEMENT ON FIRST FEDERAL OBESITY CLINICAL GUIDELINES

	The first Federal guidelines on the identification, evaluation, and 
treatment of overweight and obesity in adults are scheduled to be 
released on June 17 by the National Heart, Lung, and Blood Institute 
(NHLBI), in cooperation with the National Institute of Diabetes and 
Digestive and Kidney Diseases (NIDDK).  Due to a premature release in the 
news media of erroneous information about the guidelines, some of the key 
recommendations of the report are being released now.  The intent is to 
ensure that accurate information about the guidelines is available to the 
public.  
	The guidelines were developed by a 24-member expert panel chaired by Dr. 
F. Xavier Pi-Sunyer, director of the Obesity Research Center, 
St.Luke*s/Roosevelt Hospital Center in New York City.  They are currently 
being reviewed by 115 health experts at major medical and professional 
societies.  The NHLBI is in the process of receiving comments and 
endorsements from these experts.
	Based on the most extensive review of the scientific evidence on 
overweight and obesity conducted to date, these clinical practice 
guidelines for physicians present a new approach for the assessment of 
overweight and obesity and establish principles of safe and effective 
weight loss.
	According to the guidelines, assessment of overweight involves 
evaluation of three key measures--body mass index (BMI), waist 
circumference, and a patient*s risk factors for diseases and conditions 
associated with obesity.
	The guidelines* definition of overweight is based on research which 
relates body mass index to risk of death and illness.  The expert panel 
that developed the guidelines defined overweight as a BMI of 25 to 29.9 
and obesity as a BMI of 30 and above, which is consistent with the 
definititions used in many other countries. BMI describes body weight 
relative to height and is strongly correlated with total body fat content 
in adults.  According to the guidelines, a BMI of 30 is about 30 pounds 
overweight and is equivalent to 221 pounds in a 6' person and to 186 
pounds in someone who is 5'6".
	The panel recommends that BMI be determined in all adults.  People of 
normal weight should have their BMI reassessed in 2 years.
	According to a new analysis of the National Health and Nutrition 
Examination Survey (NHANES III), as BMI levels rise, average blood 
pressure and total cholesterol levels increase and average HDL or good 
cholesterol levels decrease.  Men and women in the highest obesity 
category have five times the risk of hypertension, high blood 
cholesterol, or both compared to individuals of normal weight.
	The guidelines recommend weight loss to lower high blood pressure, to 
lower high total cholesterol and to raise low levels of HDL or good 
cholesterol, and to lower elevated blood glucose in overweight persons 
with two or more risk factors and in obese persons who are at increased 
risk. They recommend that overweight patients without risk factors work 
on maintaining current weight or preventing further weight gain.
	According to the guidelines, 97 million American adults -- 55 percent of 
the population -- are now considered overweight or obese.  These 
individuals are at increased risk of illness from hypertension, lipid 
disorders, type 2 diabetes, coronary heart disease, stroke, gallbladder 
disease, osteoarthritis, sleep apnea and respiratory problems, and 
certain cancers. The report of the guidelines also notes that obesity is 
associated with higher death rates and, after smoking, is the second 
leading cause of preventable death in the U.S. today. The total costs 
attributable to obesity-related disease approaches $100 billion annually.
	In addition to measuring BMI, health care professionals can assess an 
individual patient*s risk status through evaluating risk factors for 
obesity, such as elevations in blood pressure or family history of 
obesity-related disease. At a given level of overweight or obesity, 
patients with additional risk factors are considered to be at higher risk 
for health problems, requiring more intensive therapy and modification of 
any risk factors.
	Physicians are also advised to determine waist circumference, which is 
strongly associated with abdominal fat.  Excess abdominal fat is an 
independent predictor of disease risk.  The panel concluded that waist 
circumference is a better marker of abdominal fat and a better predictor 
of disease risk than the current method of calculating the waist-to-hip 
ratio.  A waist circumference of over 40 inches in men and over 35 inches 
in women signifies increased risk in those who have a BMI of 25 to 34.9.
	The new guidelines stress that there are no new or magic cures for 
weight loss. The most successful strategies for weight loss include 
calorie reduction, increased physical activity, and behavior therapy 
designed to improve eating and physical activity habits.  The guidelines 
advise physicians to have their patients try lifestyle therapy for at 
least 6 months before embarking on physician-prescribed drug therapy. 
Weight loss drugs approved by the FDA for long-term use may be tried as 
part of a comprehensive weight loss program that includes dietary therapy 
and physical activity in carefully selected patients (BMI *30 without 
additional risk factors, BMI * 27 with two or more of the following risk 
factors--diabetes, high blood pressure, high blood cholesterol, and sleep 
apnea) who have been unable to lose weight or maintain weight loss with 
conventional nondrug therapies.  Drug therapy can also be used during the 
weight maintenance phase of treatment. However, drug safety and 
effectiveness beyond one year of total treatment have not been 
established.
	When published, Clinical Guidelines on the Identification, Evaluation, 
and Treatment of Overweight and Obesity in Adults will be distributed to 
primary care physicians in the U.S. as well as to other interested health 
care practitioners.  It will also be available on the NHLBI website -- 
http://www.nhlbi.nih.gov/nhlbi/ on June 17.