Healthy body weight is defined as a body mass index (BMI) of 18.5 to 24.9 kg/m2. Overweight is defined as a BMI between 25 and 29.9 kg/m2, and obesity is defined as a BMI >30 kg/m2. Maintaining a healthy weight throughout the life cycle is important to achieve optimum quality of life, maintain physical functions and reduce medical complications.
Significant weight loss is defined as a loss of more than 5 percent of body weight during a 30-day period or more than 10 percent of body weight during a 180-day period. It is an important predictor of morbidity and mortality. Weight loss of more than 10 percent of body weight during a 30-day period is considered to represent protein-energy malnutrition. Contributing factors to weight loss must be identified to implement appropriate care.
Significant weight gain occurs when BMI increases from overweight (25-29.9 kg/m2) to obesity (>30 kg/m2). In addition to identifying contributing factors, the person's readiness to change their food intake and change their amount of physical activity must be determined. An individualized plan for weight management includes both caloric reduction and physical activity.
Best Practice Prevention And Management of Unintended Weight Loss (PDF format)
Developed by dietitians in the Texas Department of Aging and Disability Services (DADS) Quality Monitoring Program, this resource provides evidence-based best-practice guidelines for addressing unintended weight loss in the long-term care setting. Handouts on medications that contribute to weight loss, treatable causes of weight loss, and care plans for unintended weight loss are included.
Best Practice Prevention Management of Unintended Weight Gain (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this resource provides evidence-based best-practice guidelines for addressing unintended weight gain in the long-term care setting. Handouts on waist circumference and medical risk, resources for increasing physical activity and care plans for unintended weight gain are included.
Best Practice Recommendations for Weight Loss at the End of Life
Developed by dietitians in the DADS Quality Monitoring Program, this resource provides evidence-based best practice guidelines for addressing weight loss at the end of life in the long-term care setting. A palliative care form and care plan are included.
The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obese Adults
Evidence-based best practice guidelines from the National Heart, Lung and Blood Institute. This resource provides the basic tools needed to appropriately assess and manage people who are overweight or obese.
Mini Nutritional Assessment
An assessment tool provided by the Nestle Nutrition Institute. This link directs the viewer to the mini assessment tool in English and Spanish. Additional anthropometric measurement tools that can aid healthcare professionals in all settings also are available.
American Medical Directors Association (AMDA)
Dedicated to long-term care medicine, the AMDA has an extensive selection of educational, informational and problem-solving tools for practitioners and medical directors in long-term care settings. AMDA’s tools and products are developed through its Clinical Practice Committee. Individual titles may be selected. Anyone can order a product, with members getting a significant discount. Altered Nutritional Status is one clinical practice guideline used by dietitians in the DADS Quality Monitoring Program.
The American Dietetic Association (ADA)
This association provides trustworthy, science-based food and nutrition information for the public and health professional. Topics for the public include Healthy Weight, Eat Right Nutrition Tips, Good Nutrition Reading List and a body mass index (BMI) calculator. Resources for health professional include medical nutrition therapy and position papers such as: Weight Management; Individualized Nutrition Approaches for Older Adults in Health Care Communities; and Ethical and Legal Issues in Nutrition, Hydration and Feeding.
The National Center on Physical Activity and Disability (NCPAD)
NCPAD is an information center concerned with physical activity and disability. Their goal is to provide options and information on various activities. This resource offers a page on nutrition. Information can be accessed for people with Alzheimer’s disease and those with intellectual disabilities. The NCPAD's slogan is "Exercise is for EVERY body."
Weight-control Information Network (WIN)
From the U.S. Department of Health and Human Services (HHS), National Institutes of Health, and National Institute of Diabetes and Digestive and Kidney Diseases, this resource provides the public, health professionals, the media and Congress with up-to-date, science-based information on weight control, obesity, physical activity and related nutritional issues. They also offer publications, such as Do You Know the Health Risks of Being Overweight?
Texas Diabetes Council Toolkit
This toolkit, which was prepared by an interdisciplinary team of certified diabetes educators and professional staff from the Texas Department of State Health Services Diabetes Prevention and Control Program, is for Texas practitioners and diabetes educators working with patients who have diabetes. Many partners contribute to its development, revision and distribution.
Interactive Dietary Reference Intake (DRI) for Healthcare Professionals
Provided by the U.S. Department of Agriculture, National Agricultural Library, Food and Nutrition Information Center, this tool can be used to calculate daily nutrient recommendations based on the Dietary Reference Intakes (DRIs). These represent the most current scientific knowledge on nutrient needs, developed by the National Academy of Science’s Institute of Medicine. Individual requirements may be higher or lower than the DRIs. This website has helpful links to Lifecycle Nutrition, Food Guide Pyramid Resources and BMI calculations.
PowerPoint Presentation – Nutrition Care: Preventing Unintended Weight Loss in LTC Facilities
Developed by dietitians in the DADS Quality Monitoring Program, this presentation provides evidence-based best-practice guidelines for preventing unintended weight loss in the long-term care setting. Presentation in HTML | Presentation in PDF
PowerPoint Presentation – Healthy Weight Management
Developed by dietitians in the DADS Quality Monitoring Program, this presentation provides evidence-based best practice guidelines for managing both unintended weight loss and weight gain in the long-term care setting. Presentation in HTML | Presentation in PDF
Power Point Presentation – Liberalizing Diets and the Dining Experience
Developed by dietitians in the DADS Quality Monitoring Program, this presentation provides evidence-based best-practice guidelines for preventing weight loss and for enhancing dining service. Presentation in HTML | Presentation in PDF
Care Plan – Unintended Weight Loss - Dependence (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this tool provides evidence-based best-practice guidelines for managing unintended weight loss in the long-term care setting.
Care Plan – Unintended Weight Loss – Depression and Diet (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this tool provides evidence-based best-practice guidelines for managing unintended weight loss in the long-term care setting.
Care Plan – Unintended Weight Gain – Obesity and Sleep Apnea (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this tool provides evidence-based best-practice guidelines for managing unintended weight gain in the long-term care setting.
Care Plan – Weight Loss at the End of Life (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this tool provides evidence-based best-practice guidelines for managing weight loss at the end of life in the long-term care setting.
Best Practice Management of Intended Weight Gain handout (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this handout provides evidence-based best-practice guidelines for managing intended weight gain.
Best Practice Management of Unintended Weight Gain handout (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this handout provides evidence-based best-practice guidelines for managing unintended weight gain.
Best Practice Management of Intended Weight Loss handout (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this handout provides evidence-based best-practice guidelines for managing intended weight loss.
Best Practice Management of Unintended Weight Loss handout (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this handout provides evidence-based best-practice guidelines for managing unintended weight loss.
Best Practice Dining/Meal Service Techniques (PDF format)
Developed by dietitians in the DADS Quality Monitoring Program, this handout provides evidence-based best-practice guidelines to improve dining and meal service techniques.
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American Medical Directors Association. Altered Nutritional Status in the Long-Term Care Setting Clinical Practice Guideline. Columbia, MD: AMDA 2010.
American Dietetic Association. Position of the American Dietetic Association: Liberalization of the Diet Prescription Improves Quality of Life for Older Adults in Long-Term Care. Journal of the American Dietetic Association 2005; 105 (12): 1955-1965.
American Dietetic Association. Position Paper of the American Dietetic Association: Nutrition Across the Spectrum of Aging. Journal of the American Dietetic Association 2005; 105 (4): 616-633.
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American Dietetic Association. Practice Paper of the American Dietetic Association: Individualized Nutrition Approaches for Older Adults in Health Care Communities. Journal of the American Dietetic Association 2010; 110 (10): 1554-1563.
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Houston DK, Nicklas BJ, Zizza CA. Weighty Concerns: The Growing Prevalence of Obesity among Older Adults. Journal of the American Dietetic Association 2009; 109 (11): 1886-1895.
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Barclay L. Waist Circumference Linked to All-Cause Mortality in Older Adults. Medscape Medical News August 9, 2010. www.medscape.com
Kivimaki MG, Batty D, et al. Association between common mental disorder and obesity over the adult life course. The British Journal of Psychiatry 2009; 195: 149-155.
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Flood M, Newman AM. Obesity in Older Adults. Journal of Gerontological Nursing 2007: 19-34
Lang IA, Llewellyn DJ, et al. Obesity Physical Function, and Mortality in Older Adults. Journal of the American Geriatrics Society 2008; 56 (8): 1474-78.
Chernoff R. Dietary Management of Older Subjects with Obesity. Clinics in Geriatric Medicine 2005; (21) 725-733.
Bales CW, Buhr G. Is Obesity Bad for Older Persons? A Systematic Review of the Pros and Cons of Weight Reduction in Later Life. Journal of American Medical Association June 2008; 302-312.
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For questions or comments, please contact us at TQM@dads.state.tx.us.
Updated: April 3, 2013