Beginning the Physical Exam: General Survey, Vital Signs, and Pain

Question 1

EVALUATION OF BODY MASS INDEX (BMI),

HEIGHT & WEIGHT

Answer 1

BMI=

Weight (lbs) x 700

Height (in)

BMI <18.5 = underweight

BMI 18.5-24.9 = normal

BMI 25.0-29.9 = overweight

BMI 30.0-34.9 = obesity, class I

BMI 35.0-39.9 = obesity, class II

BMI >/= 40 = extreme obesity, class III

Question 2

RECOMMENDATIONS FOR WEIGHT

LOSS

Answer 2

• The most effective diets combine realistic weight loss goals with exercise and behavioral reinforcements
• Encourage patients to walk 30 to 60 minutes 5 or more days a week, or a total of at least 150 minutes a week. Pedometers help patients match distance in steps with calories burned
• The total calorie deficit goal, usually 500 to 1,000 kilocalories a day, is more important than the type of diet. Since many types of diets have been studied and appear to confer similar results, support the patient’s preferences as long as they are reasonable. Consider low-fat diets for those with dyslipidemias.
• Encourage proven behavioral habits such as portion-controlled meals, meal planning, food diaries, and activity records
• Follow professional guidelines for pharmacologic therapies in patients having high weights and morbidities who do not respond to conventional treatment