2.0.0.0 AS­SESS­MENT

At each rou­tine pa­tient en­counter, BMI should be cal­cu­lat­ed as weight di­vid­ed by height squared (kg/m2) (21). BMI should be clas­sified to de­ter­mine the pres­ence of over­weight or obe­si­ty, dis­cussed with the pa­tient, and doc­u­ment­ed in the pa­tient record. In Asian Amer­i­cans, the BMI cut­off points to define over­weight and obe­si­ty are lower than in other pop­u­la­tions (Table 8.1) (22,23). Providers should ad­vise pa­tients who are over­weight or obese that, in gen­er­al, high­er BMIs in­crease the risk of car­dio­vas­cu­lar dis­ease and all-‍cause mor­tal­i­ty. Providers should as­sess each pa­tient’s readi­ness to achieve weight loss and joint­ly de­ter­mine weight-‍loss goals and in­ter­ven­tion strate­gies. Strate­gies may in­clude diet, phys­i­cal ac­tiv­i­ty, be­hav­ioral ther­a­py, phar­ma­co­log­ic ther­a­py, and metabol­ic surgery (Table 8.1). The lat­ter two strate­gies may be pre­scribed for care­ful­ly se­lect­ed pa­tients as ad­juncts to diet, phys­i­cal ac­tiv­i­ty, and be­hav­ioral ther­a­py.

Table 8.1—Treat­ment op­tions for over­weight and obe­si­ty in type 2 di­a­betes