COMMENTARY

Recording Weight Advisable at All Ages in General Medicine

Sébastien Vermeulen, MD

Disclosures

June 08, 2022

BRUSSELS ― Obesity and related disorders are a growing problem in the Western world, and Belgium is no exception. The numbers show that work also needs to be done in terms of screening.

However, meticulously recording weight at all ages can provide valuable information and offer a number of benefits. If we consider the patient population as a whole, recording weight can help us detect patients who are overweight or obese and thus at risk of developing a metabolic syndrome. Conversely, underweight patients can also be identified.

With respect to weight loss, recording weight can be essential to further document the history and identification of both the weight loss itself and the time frame. This can be important, first of all, for detecting malignancies. But in the case of geriatric patients at risk of frailty, proper documentation can also be useful for monitoring and optimal treatment.

Thyroid conditions such as Graves' disease and toxic multinodular goiter can also cause weight loss. On the other hand, the proper recording of weight can be important to quickly adjust the strategy for some chronic conditions. Thus, in patients with heart failure, signs of incipient decompensation can be detected promptly, and the medication strategy reviewed accordingly.

Weight gain can be a side effect of the medication used to treat certain other conditions, with psychotropics being perhaps the best-known example. In this case, recording weight can be crucial for quickly detecting weight gain, and consequently for adjusting medication if necessary, assessing the overall risk, and considering a lifestyle intervention if required. We should recognize the importance of somatic care and management of cardiovascular risk in psychiatric patients.

As for the pediatric population specifically, proper recording of biometric data can be particularly useful for quickly calculating the dosage of prescribed medications. The potential pitfall here is relying on the weight stated by the parents: a Dutch study demonstrated marked differences between reported measurements and reliable data measured by biometrics. So, practitioners should be committed to recording parameters themselves at the practice.

The data from various countries show that biometric data (weight, height, abdominal girth) are not recorded very often in general medicine.

As for recording weight in the general population, the numbers are very low in practice; recording is not done routinely. A study conducted in the United Kingdom shows that one patient in three has his or her weight recorded each year and that this procedure is repeated more often in women and patients with comorbidities.

For these specific populations, including patients with type 2 diabetes or obese patients, the numbers vary. The authors of an Australian study reviewed 270,000 records of adult patients and observed that weight was only recorded in 22.2% of cases. As a point of interest, this rate was even worse for abdominal girth: just 4.3%!

The Dutch numbers reveal a recording rate of 25% in overweight patients; other figures show that, at least once every 3 years, weight is logged in the medical records of 90% of diabetic patients. The numbers are much lower in patients who have no comorbidities, and this is a global trend across different groups of individuals.

Sébastien Vermeulen, MD, a general practitioner, was born and raised in Hal (Zoersel), Belgium. His many interests include psychiatry, palliative care, diabetes, obesity, and otorhinolaryngology. In addition to his private practice, he works as a general practitioner at the forensic psychiatry center in Antwerp.

This article was translated from MediQuality.

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