Keywords: body mass index; electronic health records; obesity; primary health care; public health surveillance; waist circumference.
Primary care providers can deliver tailored advice and support to patients who are overweight or have obesity. The 2020 Canadian Adult Obesity Practice Guideline for primary care providers recommended that patients’ waist circumference (WC) be measured if their height and weight place them in the overweight or Class I obesity category. The guideline does not recommend how often providers should measure WC nor describe how often this is measured in current practice. We reviewed electronic medical records (EMRs) of 707,819 Canadian adult patients aged 40 and older. Among them, 48.7% had 1 or more body mass index (BMI) recorded; 11.5% had at least 1 waist measurement recorded. Of those with a BMI classified as overweight or having Class I obesity, 23.7% had at least 1 WC measurement recorded, which differed by chronic disease. WC was documented in more patients who had diabetes mellitus (36.8%) than hypertension (26.1%), or osteoarthritis (24.3%). This difference may be reflective of more specific advice in diabetes guidelines. To our knowledge, this is the first study to describe documentation of WC measurement for patients who are overweight or have Class I obesity in Canadian primary care EMRs across obesity-related conditions.