Procedure

1. Gather Anthropometric Data

   • Retrieve the user's current height and gender using get_user_preferences.
   • Ask the user for their current weight and a precise measurement of their wrist circumference (measured at the narrowest point of the wrist).

2. Determine Body Frame Classification

   • Calculate the Frame Size Ratio ($r$) using the formula: $r = \text{Height (cm)} / \text{Wrist Circumference (cm)}$.
   • Classify the frame size based on the following clinical thresholds:
     • Men: Small ($r > 10.4$), Medium ($r = 9.6–10.4$), Large ($r < 9.6$).
     • Women: Small ($r > 11.0$), Medium ($r = 10.1–11.0$), Large ($r < 10.1$).
   • Alternatively, for women under 5'2", classify as Small (< 5.5"), Medium (5.5"–5.75"), or Large (> 5.75").

3. Establish Ideal Body Weight (IBW)

   • Use the frame classification to identify the appropriate target range.
   • For Small Frames, target the lower end of the standard Metropolitan Life weight spectrum.
   • For Large Frames, target the upper end of the spectrum, acknowledging that a BMI of 26–27 may be appropriate for these individuals.
   • Use compute_ideal_weight to compare these frame-adjusted values against standard formulas (e.g., Devine or Hamwi).

4. Calculate Nutritional Stability

   • Calculate the Percentage Ideal Body Weight (%IBW): $\text{%IBW} = (\text{Current Weight} / \text{Ideal Body Weight}) \times 100$.
   • Evaluate the result against the clinical target range of 90–120% of IBW.

5. Integrate Complementary Metrics

   • To ensure a comprehensive health view, use compute_waist_to_height to check for abdominal adiposity.
   • Use estimate_body_fat to verify if high weight is driven by lean mass or fat mass.

6. Update Goals and Records

   • Store the frame size classification and the adjusted weight target using remember and update_preferences.
   • Provide the user with a summary of how their frame size influences their healthy weight range compared to a generic BMI calculation.