Overweight and Obesity

Signs and Symptoms

Adolescents (non-pregnant and non-post-partum):

BMI-for-age:

• Overweight: ≥ +1 to < +2
• Obese: ≥ +2

Adults (non-pregnant and non-post-partum):

BMI:

• Overweight: 25.0 to 29.9
• Obese: ≥ 30.0

Pregnant and post-partum women up to 6 months:

MUAC:

• Overweight/Obese: ≥ 300 mm

MEDICAL CARE FOR OVERWEIGHT AND OBESITY

• Check and treat or refer any associated medical conditions such as hypertension, HIV and diabetes.
• Check cholesterol levels if available.

NUTRITIONAL CARE FOR OVERWEIGHT AND OBESITY

• Counsel the client on making changes to diet and physical activity to attain a healthy weight range that is within the BMI of 18.5 to 25.0.
• Reducing the intake of highly processed food, fatty food, junk foods, sweet drinks, and sugary foods
• Increasing the consumption of fresh fruits and vegetables
• Doing at least 30 minutes of physical exercise every day, such as walking, jogging, and doing household chores
• Reducing portion sizes
• If the client is pregnant, do not encourage weight loss, but set appropriate weight gain targets for pregnancy and encourage healthy eating habits.

DISCHARGE CRITERIA FROM TREATMENT PROGRAMMES

The table below summarises the discharge criteria of children from OTP and NRU

NRU OTP

Refer children 6 months to 15 years to OTP if:

• Appetite returned (passed appetite test for RUTF – the child is eating more than 75 percent of daily prescription of RUTF) and start of weight gain
• Medical complication resolving
• Bilateral pitting oedema decreasing
• If marasmic kwashiorkor admission: bilateral pitting oedema resolved
• Clinically well and alert

In case there’s no OTP:

Children 6-59 months

• MUAC ≥ 12.5 cm
• WFH ≥ -2 z-score
• No bilateral pitting oedema for two consecutive weeks
• Clinically well and alert

Children 5 – 15 Years

• MUAC > 13.0cm (5 – 9 years)
• MUAC > 16.0cm (10-15 years)
• No bilateral pitting oedema for 2 consecutive weeks
• Clinically well and alert

Infants 0- 6 months (Breastfeeding)

• Successful re-lactation with effective suckling
• Good appetite, clinically well & alert
• Weight gain on either exclusive breastfeeding is satisfactory.

Infants 0- 6 months (Not Breastfeeding)

• WFH ≥ - 2 z-score for 2 consecutive weeks
• No oedema for 2 consecutive weeks
• Clinically well and alert, no medical problem

Children 6-59 months

• MUAC >12.5cm
• WFH >-2 Z scores
• No bilateral pitting oedema for 2 consecutive weeks
• Clinically well and alert

Children 5 – 15 Years

• MUAC > 13.0cm (5 – 9 years)
• MUAC > 16.0cm (10-15 years)
• No bilateral pitting oedema for 2 consecutive weeks.
• Clinically well and alert