What is the adjusted body weight (ABW) for a 5'4" female weighing 213 pounds?

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Adjusted Body Weight Calculation for a 5'4", 213 lbs, 60-Year-Old Female

Your adjusted body weight (ABW) should be calculated using the formula: ABW = IBW + 0.25 × (Actual Weight - IBW), where IBW is your ideal body weight based on your height. 1

Step-by-Step Calculation

1. Calculate Ideal Body Weight (IBW)

  • For females, the standard formula is: IBW (kg) = 48.67 kg + 1.65 kg per inch over 5 feet 2
  • At 5'4" (64 inches), that's 4 inches over 5 feet
  • IBW = 48.67 kg + (1.65 kg × 4) = 48.67 kg + 6.6 kg = 55.27 kg 2

2. Convert Actual Weight to Kilograms

  • 213 lbs = 96.6 kg 3

3. Apply the Adjusted Body Weight Formula

  • ABW = 55.27 kg + 0.25 × (96.6 kg - 55.27 kg)
  • ABW = 55.27 kg + 0.25 × 41.33 kg
  • ABW = 55.27 kg + 10.33 kg
  • ABW = 65.6 kg (approximately 144.6 lbs) 1

Clinical Significance of Using ABW

  • The ABW calculation is important because it accounts for the fact that adipose tissue has different metabolic activity than lean tissue 3
  • Using ABW is particularly relevant when your actual body weight is >115% of your ideal body weight, as in your case 1
  • The National Kidney Foundation guidelines specifically recommend using ABW for nutritional assessment and prescription when edema-free body weight is less than 95% or greater than 115% of standard weight 1

Important Considerations

  • The adjustment factor of 0.25 in the formula recognizes that only a portion of excess weight is metabolically active tissue 3
  • Different clinical contexts may use slightly different adjustment factors (0.25,0.33, or 0.4) depending on the specific application 3, 4
  • For medication dosing, ABW may be preferred over actual body weight to prevent potential overdosing 3
  • For nutritional calculations, ABW helps provide more appropriate protein and energy requirements 1, 5

Potential Pitfalls

  • Using actual body weight for nutritional assessment or medication dosing in obesity can lead to overestimation of requirements 1
  • Using ideal body weight alone may underestimate requirements 5
  • The ABW calculation should be considered a starting point; clinical judgment and ongoing assessment remain important 1
  • Different formulas for ideal body weight exist, which can affect the final ABW calculation 6, 7

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Determination of ideal body weight for drug dosage calculations.

American journal of hospital pharmacy, 1983

Guideline

Adjusted Body Weight Calculation and Clinical Applications

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Adjusted body weight, pro: evidence to support the use of adjusted body weight in calculating calorie requirements.

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2005

Research

Universal equation for estimating ideal body weight and body weight at any BMI.

The American journal of clinical nutrition, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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