Obesity

Alzheimer-type dementia - Obesity Factor

The Alzheimer-type dementia SOP includes a factor of "being obese".  This term is defined in the SOP.  The RMA has also issued a SOP for morbid obesity.  If there is a history of "being obese" but the claim for Alzheimer-type dementia does not succeed via this factor, you will be asked to consider whether there is a history of morbid obesity, as this is an extreme form of obesity.

RMA definition of being obese

In this Statement of Principles the Repatriation Medical Authority has defined being obese as meaning "an increase in body weight by way of fat accumulation which results in a Body Mass Index (BMI) of 30 or greater.

The measurement used to define “being obese” is the Body Mass Index (BMI).

The BMI = W/H2 and where:

W is the person’s weight in kilograms and

H is the person’s height in metres".

(For Imperial weights and measures, BMI = wt. in lbs/(ht in inches2) x 703.1).

This definition excludes weight gain not resulting from fat deposition such as gross oedema, peritoneal or pleural effusion, or muscle hypertrophy.  "Being obese" develops when energy intake is in excess of expenditure for a sustained period of time.

Establishing the presence of obesity

If it is not possible to obtain specific height/weight measurements, a medical comment that the veteran or member was obese will be sufficient.  If height/weight measurements can be obtained, the BMI formula should be applied.

A history of obesity may be documented in the evidence.  However, the veteran or member may not have sought medical attention and the condition may not have been recorded in medical records.  In addition, doctors' and hospitals' records may have been destroyed or can no longer be obtained.

Therefore, a statement by the veteran about his or her weight at a particular time will generally be accepted, unless there is contradictory evidence.  This weight can then be used to calculate whether the veteran was obese at that time.

Last reviewed for CCPS 16 September 2011.

Investigative Documents

Preliminary questions [41444]

587       the veteran has a history of obesity.

41479  the veteran has established the causal connection between the obesity and operational service for the clinical onset of Alzheimer-type dementia.

Clinical onset and operational service [41479]

8665     the veteran was obese for at least 10 years before the clinical onset of the condition under consideration.

591       the obesity was caused by operational service.

or

9004     the veteran has a history of morbid obesity.

41481 the morbid obesity was present for at least 10 years before the clinical onset of the condition under consideration.

9005     the morbid obesity is causally related to operational service.