What is the recommended weight loss for a patient with a body mass index (BMI) associated with a weight of 72 kilograms (kg) and a height of 5 feet 4 inches?

Recommended Weight Loss for This Patient

For a patient weighing 72 kg at 5 feet 4 inches tall (BMI 27.4 kg/m²), an initial weight loss goal of 3.6 to 7.2 kg (5-10% of body weight) is recommended to achieve clinically meaningful health benefits. 1

BMI Classification and Health Risk

• This patient's BMI of 27.4 kg/m² falls into the overweight category (BMI 25-29.9 kg/m²), which is associated with increased cardiovascular risk compared to normal weight 2, 3
• At this BMI with comorbidities present, the patient qualifies for comprehensive lifestyle intervention and potentially pharmacotherapy 1
• Waist circumference should be measured; if ≥35 inches (89 cm) in women or ≥40 inches (102 cm) in men, this intensifies the need for weight management 1

Specific Weight Loss Targets

Initial target: 3.6-7.2 kg (5-10% of 72 kg)

• A 5% weight loss (3.6 kg) is the FDA-approved threshold for clinically meaningful improvement and begins to show benefits in glycemic control, triglycerides, and quality of life 1, 4
• A 10% weight loss (7.2 kg) produces greater improvements in systolic blood pressure (approximately 3 mmHg reduction if hypertensive), diastolic blood pressure, HDL cholesterol, and hemoglobin A1c (0.6-1% reduction if diabetic) 2, 4
• Weight loss beyond 10% may be needed for conditions like obstructive sleep apnea or non-alcoholic steatohepatitis, but the initial goal should remain modest 4

Practical Implementation Strategy

Energy deficit approach:

• For overweight patients (BMI 25-29.9 kg/m²) with cardiovascular risk factors, create a 500 kcal/day deficit 1
• This produces approximately 0.45 kg (1 pound) per week weight loss 1
• Expected timeline: 10% weight loss achieved in approximately 6 months with high-intensity intervention 1

Treatment intensity:

• High-intensity comprehensive lifestyle intervention requires ≥14 visits in 6 months (weekly for first month, biweekly for months 2-6) 1
• Monthly follow-up thereafter for 1 year to prevent weight regain 1

Important Clinical Considerations

• Do not set unrealistic expectations: Patients with obesity typically set goals that are too ambitious, which leads to failure and discouragement 1
• Emphasize health benefits over scale numbers: Even 5% weight loss provides substantial health improvements including reduced diabetes risk, improved blood pressure, and better lipid profiles 1, 4
• The relationship between weight loss and glycemic improvement is particularly close: Small amounts of weight loss (5-10%) are sufficient to prevent progression from impaired glucose tolerance to type 2 diabetes 4
• Continued intervention contact after initial weight loss is critical: Most patients will plateau at 6 months and require ongoing support to maintain losses and prevent the "yo-yo effect" 1

When to Intensify Treatment

If the patient has previously attempted comprehensive lifestyle intervention without success and has:

• BMI ≥27 kg/m² with comorbidities: Consider adding pharmacotherapy 1
• The current BMI of 27.4 kg/m² with comorbidities qualifies this patient for medication-assisted weight loss if lifestyle intervention alone is insufficient 1