For obese people, the use of girth measurements alone may be suitable, as a skin fold test is not likely to be possible due to the inability to apply the skin fold calipers.

Guidelines:

• Girth measurements should ALWAYS be presented to the client as optional and never forced upon them.

• ALWAYS ask for a client's consent before performing girth measurements.

• Explain to the client exactly how the measurements are taken prior to you performing them.

• Although recommended, it is NOT essential that all girth measurements be taken. Some clients may only wish to have one measurement taken.

• The following girth measurements are written in the order that they should be performed to minimise client discomfort.

• When taking girth measurements, it should be a quick and easy process for the client. If you are not confident in how to perform them, then DON’T.

• Practice on friends and family until you are confident you can perform girth measurements correctly.

• It may only be necessary to perform the biceps and/or thigh measurement on the clients favored side.

• Record all data so you can track the client’s progress and so the girth measurements can be retaken more accurately when the client is due for reassessment.

• It is neither necessary nor recommended that clients remove clothing during the taking of girth measurements.

• The tape should be lightly taut on the skin during measurements. If it is too tight, this will cause depressions on the skin surface, resulting in inaccurate measurements.

IMPORTANT:

IF you have not built a strong rapport with the client and sense they are not entirely comfortable with you, then DO NOT take the girth measurements and address them at a later date when rapport has been developed.

Sites and measuring procedures are as follows:

1. Biceps

1. Ensure the client is seated with their right-elbow flexed at a 90degree angle.

2. Measure the distance from the most superior, lateral border of the acromion process (top edge of the shoulder) to the olecranon process (point of the elbow).

3. Use a pen to mark the halfway point and record the distance to the halfway point (this helps the following assessments to be quick and easy).

4. Measure around the bicep at the marked site and record the measurement (ensure client is not flexing muscles).

5. Repeat on the left arm.

2. Thighs

1. Ensure the client is in a seated position and knees are bent at a 90degree angle (muscles in the legs should be relaxed).

2. Give the client one end of the measuring tape and ask them to place it at the point where their right-leg attaches to their torso (anterior surface of the iliac crest).

3. With client still holding one end of the tape, measure to the superior border of the patella (knee cap).

4. Once you have measured the distance between the two points, use a pen to mark the halfway point or ask the client to hold their finger at halfway point. Record the distance to the halfway point.

5. Measure around the thigh keeping the measuring tape inline with marked site and record the measurement.

6. Repeat on the left-leg.

3. Chest

1. Ensure the client is standing with their arms abducted to 90degrees and elbows flexed at a 90degree angle (with forearms parallel to the floor).

2. Position yourself behind the client, and pass the tape measure around the upper chest, so you are holding both ends of the tape.

3. Ask the client to position the tape at nipple height (or slightly higher).

4. Client is to then rest their arms to the side of their body and breathe normally. Adjust the measuring tape where necessary.

5. With the measuring tape taut, record the measurement.

4. Waist

1. Ensure the client is standing with their arms abducted to 90degrees and elbows flexed at a 90degree angle (with forearms parallel to the floor).

2. Ask the client to use their right-hand to place one end of the tape measure directly over the navel.

3. Ask the client to breathe normally and very slowly turn 360degreees in a clockwise direction. This ensures the measuring tape remains the same height as the navel.

4. Record the measurement.

5. Hips

1. Ensure the client is standing with their arms abducted to 90degrees and elbows flexed at a 90degree angle (with forearms parallel to the floor).

2. Ask the client to use their left-hand to place one end of the tape measure directly over the widest point of their left-hip.

3. Ask the client to breathe normally and very slowly turn 360degreees in a clockwise direction. This ensures the measuring tape remains the same height as the hip.

4. Record the measurement.