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Another option is to measure the patient's waist circumference. With the patient standing, measure the waist just above the hip bones. The patient may have excess body fat if the waist measures:

Interpreting and Acting on the BMI. If the BMI falls above 25, or the weight is greater than the upper limit of recommended weight for height, a nutrition assessment is in order. Engage the patient in a 24-hour dietary recall and compare the intake of food groups and number of servings per day with current recommendations. Or choose a screening tool and provide appropriate counseling or referral. You may wish to review the types of foods in different food groups, using the helpful diagram found in Table 3-5, "Food Guide Pyramid: A Guide to Daily Food Choices" (p._). Remember that carbohydrates and protein furnish 4 calories per gram, and fat yields 9 calories per gram.

If the BMI falls below 17, or the weight is less than the low end of the range of weight for height, be concerned about possible anorexia nervosa, bulimia, or other medical conditions. These conditions are summarized in Table 3-6,

Eating Disorders and Excessively Low BMI, p._. (See also p._for health promotion and counseling for overweight or underweight patients.)

See also Table 3-1, Height and Weight Tables for Adults Age 25 and Over, p._.

See Table 3-2, Healthy Eating: Food Groups and Servings per Day, p._. For screening tools, see

Table 3-3, Rapid Screen for Dietary Intake, p._, and Table 3-4, Nutrition Screening Checklist, p._.

Source: Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, National Institutes of Health and National Heart, Lung, and Blood Institute. June 1998.

Source: Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, National Institutes of Health and National Heart, Lung, and Blood Institute. June 1998.

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