People with specific long-term conditions such as diabetes and heart disease should have their BMI and waist-to-height ratio recorded at least once a year, NICE has said in draft guidance.
The draft guidance, says that adults with long-term conditions should have their BMI recorded annually, with additional waist-to-height measurements for those with a BMI under 35.
The new approach will help identify people at risk of weight-related complications so they can be offered appropriate support to prevent future ill-health.
While annual physical checks already take place for people with long term conditions, the recording of someone’s BMI and waist-to-height ratio is not always taking place or added to a health record. NICE hopes to reduce this inequality in care.
The quality standard does not provide a definitive list of long-term conditions but suggests services could focus on patients with COPD, diabetes (type 1 or type 2 diabetes or at high risk of developing type 2 diabetes), dyslipidaemia (abnormal levels of fats in the blood), heart failure, learning disability, obstructive sleep apnoea, peripheral arterial disease, polycystic ovary syndrome, rheumatoid arthritis, schizophrenia, bipolar disorder or other psychoses, and stroke or transient ischemic attack.
Professor Jonathan Benger, deputy chief executive and chief medical officer at NICE, said: “These simple annual measurements create opportunities for early intervention and conversations about long-term health and wellbeing. By identifying trends before they become problems, clinical practitioners can help people prevent more serious health complications down the line.
“Annual monitoring of BMI and waist-to-height ratio is a powerful tool to help prevent problems developing such as the onset of diabetes, heart disease or other obesity-related conditions.
“Once implemented, these proposed quality standards could significantly improve health outcomes for people with long-term conditions by ensuring consistent, timely support for weight management across all healthcare settings.”
The draft quality standard also covers:
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Supporting people with learning disabilities to access overweight and obesity management services
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Providing up-to-date information on available local interventions and national programmes
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Giving advice for maintaining changes and support for improving health and wellbeing after completing a behavioural intervention
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Ensuring wraparound care focusing on diet, nutrition and physical activity for adults prescribed medicines for weight management
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Annual follow-up for adults discharged from bariatric surgery services.
Dr Rebecca Payne, GP and chair of the quality standards advisory committee, said: “We want to hear from healthcare professionals and commissioners during the consultation period to understand whether the proposals we have made can be implemented in the NHS.
“NICE must focus on what matters most and in areas where it can make the biggest difference. We expect these changes to demonstrate the impact we are having on the lives of people with weight related conditions.
“Once the consultation period closes, the committee will meet again to discuss the responses, and if necessary, amend the statements. Our final quality statements will be published on the NICE website at the conclusion of this process.”
The draft quality standard is open for public consultation until 15 April 2025. It follows the publication of an updated guideline on overweight and obesity management in January 2025.
The final quality standard is expected to be published in August 2025.
