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The PaperWeight Armband

The PaperWeight Armband is a non-medical, non-intrusive tool used to identify and deal with malnutrition. It enables carers, volunteers or health and social care professionals to broach the subject of malnutrition.

Salford findings since the introduction of the paperweight armband:

  • Reduction in hospital admissions
  • 50% increase in reporting of underweight BMI in primary care after 1 year
  • Reduction in expenditure on oral nutritional supplements of over £300,000 in 3 years

A person is classed as malnourished if they have:

  • A BMI (Body Mass Index) of less than 18.5
  • Unintentional weight loss greater than 10% within the past 3-6 months
  • A BMI of less than 20 and unintentional weight loss greater than 5% within the past 3-6 months

PaperWeight Armband Order Form

Please download a copy of the form and complete the information required. Please send a copy to the email listed on the form.

Frequently Asked Questions

Why is this needed?

The Paperweight Armband is the only public health signposting tool for malnutrition. It is a non-medical, non-intrusive tool that is helping health and social care professionals identify older people at risk of malnutrition and signpost them to immediately accessible information and advice. This approach helps people and carers self-manage and address the risk of malnutrition before consulting with their GP. Healthcare professionals e.g. care homes/domiciliary care and supported housing providers may also find this useful.

Who can use this PaperWeight Armband?

Anyone! It signposts carers, relatives, care and support workers in any sector or setting. The PaperWeight Armband was intended to be used in a wide range of settings and raise awareness of the risks of malnutrition and direct people to practical nutrition advice quickly and safely.

What is the evidence base behind the size of the PaperWeight Armband?

Meta-analysis from Tang et al, cites Tsai et al. as a cross-sectional study on the elderly . The authors reported a significant association between low Mid Upper Arm circumference  (<23.5 for men, <22.0 for women) and the Mini Nutrition Assessment (MNA), which is a tool commonly used for screening and classifying nutritional status of the elderly.  This meta-analysis also states low MUAC was associated with increased mortality and poor immune response. BAPEN also cite 23.5cm as the alternative measurement cut off point:  ‘If MUAC is <23.5 cm, BMI is likely to be <20 kg/m2

How do I place an order?

If you are in Bolton, Bury, Oldham, Rochdale, Stockport or Salford please get in touch with to organise free training and resources for you and your team.

If you are outside these areas just  complete the Order form to confirm the delivery address and payment details and once this is returned we will be pleased to dispatch your Starter Pack without delay

Why is there a charge for PaperWeight Armband?

For organisations outside of Bolton, Bury, Oldham, Rochdale, Stockport or Salford, there is a charge for the Starter Pack of £130, as it is a bespoke printed product.

The PaperWeight Armband is free for healthcare and charities to use in Salford, as the printing costs are covered by the Salford Together Integrated Care Programme.

It is also free for healthcare and charities to use in Bolton, Bury, Oldham, Rochdale and Stockport thanks to funding from the GMCA Population Health programme.

Please note the PaperWeight Armband complies with infection control guidelines for single use only and is easily recycled. We have worked closely with Trustech, the North West innovation service to ensure the product is compliant with health and safety requirements, for example the glue and ink are deemed ‘non-hazardous products for wide use by the general public.’

I work in a care home and know nutrition is important. How would the PaperWeight Armband help us?

PaperWeight Armband is useful for bedbound patients or patients with dementia who may not consent to be weighed. This not a validated nutrition screening tool, however it may be used to access and allow your team to start a ‘food first’ approach to help residents gain weight before referring to a GP or dietitian. Residents should still be weighed on admission to care homes and screened for malnutrition in line with local policies and procedures.

How do I use PaperWeight Armband?

The PaperWeight Armband has a defined circumference and if someone can stick the band together at the red line, and it can slide up and down the upper arm, clearly the arm circumference is less than 23.5cm which may suggest the person has a body mass index less than 20kg/m². Mid arm muscle circumference is a well-established surrogate measure for body mass index. If you have a QR scanner (e.g. an app such as Google Goggles or similar on your smartphone) then swiping this code will redirect you to our website where you will find more information and nutrition advice. Watch the video of how to use the armband.

How long should I use this for?

We would advise you to try the suggestions in our leaflet ‘Eat, Drink, Live Well' and incorporate these suggestions into your routine for a maximum of 12 weeks, before seeking advice from your GP if there is no improvement. However, if you feel there has been a more sudden weight loss over the last few weeks, speak to your GP surgery sooner. Please recycle the PaperWeight Armband responsibly

Should I seek medical help?

We know that people want to take control of their lives and the advice above is intended to help. It is also important to know when to seek medical help. If you have followed the advice and have seen no change in your weight and/or BMI after 12 weeks or if you answer yes to any of the questions below, you should visit your GP.

  • Have you noticed sudden weight loss (10% of your body weight in 3 months)?
  • Do you have difficulties swallowing food or drinks?
  • Do you get pain in your tummy when you eat?
  • Has there been a recent persistent change in moving your bowels to looser stools and/or increased frequency?

Do I need special training?

No the instructions are on the back of the Paperweight Armband and the website along with a short video. If you are considering using this within your health improvement /working environment then please check with your lead person for nutrition, to ensure this helps meet your organisations nutrition care plan or nutrition pathway.

Our organisation has just started to use PaperWeight armband within our care home, would you like feedback?

Yes please! We would love to hear the feedback and anonymous case study reports. Please email the local Project Worker or

We have a social media campaign @PArmband and @GMNandH please tweet if you are using PaperWeight Armband and follow our activities/news.