Endocrinology General Medicine Strong — NICE CG189, WHO

BMI + Metabolic Risk Assessment

Combined BMI and waist circumference assessment for metabolic risk classification.

Score interpretation

Underweight 0–18.49

BMI < 18.5 kg/m²: Underweight.

→ Nutritional assessment. Exclude malnutrition, eating disorder, malignancy. Refer dietitian.

Normal Weight 18.5–24.99

BMI 18.5–24.9 kg/m²: Normal weight.

→ Maintain healthy lifestyle. Annual CV risk review.

Overweight 25–29.99

BMI 25–29.9 kg/m²: Overweight.

→ Lifestyle advice: 500 kcal/day deficit, 150 min exercise/week. Target 5–10% weight loss.

Obese Class I 30–34.99

BMI 30–34.9 kg/m²: Obese Class I.

→ Structured weight management programme. Consider orlistat. Screen: T2DM, hypertension, dyslipidaemia, OSAS, NAFLD.

Obese Class II 35–39.99

BMI 35–39.9 kg/m²: Obese Class II.

→ Specialist obesity service referral. Consider GLP-1 agonist (semaglutide, liraglutide). Bariatric surgery if comorbidities.

Obese Class III (Morbid) ≥ 40

BMI ≥40 kg/m²: Morbid obesity.

→ Bariatric surgery assessment. Specialist obesity centre referral. High surgical and anaesthetic risk — document.

Interpretation bands for the BMI + Waist. Apply clinical judgement and local guidance.

NICE CG189. Obesity: identification, assessment and management. 2014 (updated 2023).
WHO. Obesity and overweight. Fact sheet. 2024.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.