Obesity

Obesity Evaluation

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Obesity Evaluation

  • See Also
  1. Obesity
  2. Obesity in Children
  3. Obesity Measurement (or Obesity Screening)
  4. Obesity Risk (or Obesity Comorbid Conditions)
  5. Obesity Management
  6. Obesity Medication
  7. Dietary Supplements in Obesity
  8. Exercise in Obesity
  9. Obesity Resources
  • Indications
  1. See Obesity for diagnostic criteria
  1. Temporary Exclusions
    1. Pregnancy
    2. Lactation (allowed if milk established)
    3. Unstable mental or medical illness
  2. Possible Exclusions
    1. Cholelithiasis
    2. Osteoporosis
  3. Permanent Exclusions
    1. Anorexia Nervosa
    2. Terminal illness
  • History
  1. History of lifetime weight changes
  2. Medical conditions and medications predisposing to weight gain
    1. See Medications Associated with Weight Gain
  3. Prior weight management strategies and their effectiveness?
  4. Prior Obesity Medication use
  5. Family History of Obesity and metabolic conditions
  6. Social history
  7. Substance use (Tobacco, Alcohol, Illicit Drug use)
  8. Behavioral health (e.g. Major Depression, Anxiety Disorder, emotional stress, Trauma, PTSD)
  9. Physical Activity (work, home, Exercise)
  10. Nutrition history
    1. Meals (timing, portions, content, preparation)
    2. Habits or disordered eating that may benefit from modification (e.g. Binge Eating)
  • Exam
  1. Vital Signs
  2. Oropharynx
    1. Mallampati Score (Grades 3-4 associated with Sleep Apnea)
  3. General Exam
    1. Cardiopulmonary exam
    2. Skin exam
  4. Determine Obesity Measurements
    1. See Obesity Measurement
    2. Body Mass Index (BMI)
    3. Waist Circumference
    4. Neck circumference (best predictor of Sleep Apnea)
  • Labs
  1. Fasting Lipid profile
  2. Chemistry panel (including Fasting Serum Glucose)
  3. Thyroid Stimulating Hormone (TSH)
    1. Rarely the cause for weight gain
  • Approach
  1. See Obesity Management
  2. Evaluate Comorbid Obesity Risk
  3. Is Patient Ready and Able to lose weight?
    1. Yes: Weight Reduction Protocol
    2. No: Prevention of Weight Gain Protocol
  • Resources
  1. Frank (1998) J Am Diet Assoc 98:S44-48 [PubMed]
  2. Keating (2024) Am Fam Physician 110(2): 145-56 [PubMed]
  3. Lyznicki (2001) Am Fam Physician 63(11):2185-96 [PubMed]
  4. Rippe (1998) J Am Diet Assoc 98:S9-15 [PubMed]
  5. Speer (1997) Phys Sportsmed 25:94-107 [PubMed]
  6. (1998) AOA Treatment Adult Obesity, 2nd edition
  7. (1998) Obesity Res 6(suppl 2):51S-209S