Millions of patients will be weighed and measured every year by their GP, so they can be warned if they start to become too fat.
Weight, height and waist circumference will be added to NHS medical records and tracked throughout their lives.
Those who cross into the overweight or obese category will receive advice on how to lose weight and will be informed that their health is at risk if they do not take action.
Doctors can refer patients who are gaining weight to weight loss, cooking or exercise classes, or to special clinics where they can be prescribed weight loss injections.
Representatives hope the measure will better support the around 15 million people in England and Wales living with long-term conditions and identify those at risk of developing weight-related complications.
But doctors have been told to be cautious, as there are concerns they could offend patients who are sensitive about their weight.
The new policy is included in preliminary guidelines on weight management, published today by the care watchdog, the National Institute for Health and Care Excellence (NICE).
It applies to those living with diseases such as diabetes, heart disease, COPD, rheumatoid arthritis, stroke, and polycystic ovary syndrome.
Health professionals will be told to record the body mass index of these patients annually, with additional measurements of waist-to-height ratio for those with a BMI below 35.
The guidance says: “Health professionals should seek permission in a sensitive and non-judgemental way before discussing weight, as people may be more willing to accept the provision of support that could have a positive impact on their health.”
He warns NHS staff not to attribute all of a patient's health problems to being overweight and says they should "respect the person's choice" if they do not want to discuss their weight.
More than six in ten adults in England (64.0 per cent) are overweight or obese, up from 61.2 per cent in 2016.
The NHS website says obesity is a "serious health issue that increases the risk of many other health conditions", including type 2 diabetes, heart disease, cancer and stroke.
"Living with overweight and obesity can also affect quality of life and contribute to mental health problems, such as depression, and can also affect self-esteem."
Professor Jonathan Benger, executive vice-chair 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 later.
Annual monitoring of BMI and waist-to-height ratio is a powerful tool to help prevent problems that may develop such as the onset of diabetes, heart disease, or other obesity-related conditions.
Once implemented, these proposed standards could significantly improve health outcomes for people with long-term conditions by ensuring consistent and timely weight management support across all healthcare settings.”
NICE has previously approved the use of weight loss injections, Wegovy and Mounjaro, on the NHS, but their roll-out is limited due to cost and a lack of capacity in specialist clinics.
Demand for these drugs, which can cause people to lose up to a fifth of their body weight, continues to grow and half a million people are now estimated to be using them in the UK.
The new NICE guidance adds: “Stigma from health and care professionals can act as a barrier to accessing care for people living with overweight, obesity or fat cell accumulation and can lead to poorer health and physical outcomes during treatment.
“People who have conversations with health and care professionals about living with overweight, obesity or fat accumulation should communicate in a person-centered way, using non-judgmental and non-stigmatizing language.”
While annual physical examinations are now done for people with long-term conditions, recording of BMI and waist-to-height ratio is not always done or added to the health record.
NICE hopes to reduce this “inequality in care”.
The project guidance also includes support for people with disabilities to access services for managing overweight and obesity.
Providing advice on maintaining changes and support for improving health and well-being after completing a behavioral intervention, “rounded care” that focuses on diet, nutrition, and physical activity is also described for adults who have been prescribed medications for weight management.
The project guidance is now open for public consultation until April 15th and the final document is expected to be published in August. /Express newspaper/
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