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Assessment of the Obese Patient

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Abstract

Obesity is one of the most common conditions encountered in clinical practice. It predisposes to and is associated with a range of chronic health problems, reduced functional capacity, and impaired quality of life. A range of treatment options are available that have been shown to reduce weight and improve health. There is a broad consensus that physicians should screen patients for obesity, assess overweight and obese individuals for associated health problems including risk for cardiovascular disease, diabetes, sleep apnea and help patient select a treatment approach that is appropriate for their health and readiness to change their lifestyle behaviors. While the BMI and waist circumference remain the primary tools for assessing health risks associated with weight, it is widely acknowledged that there are limitations to risk screening that is based solely on BMI. Recent data suggest that the relationships between weight, morbidity, and mortality are not straightforward. As a result, a number of strategies have been proposed for assessing risk in obese patients in an effort to allow interventions to be targeted to those at greatest risk of adverse health outcomes. When seeing an overweight or obese patient the clinician should evaluate the weight history, previous attempts at weight loss, eating and exercise habits and inquire about medications that might promote weight gain. While uncommon, patients are often concerned that they have a secondary cause of obesity and clinicians should understand the approach to screening for hypothyroidism, hypercortisolism, and genetic forms of obesity. Finally, clinicians should assess a patient’s readiness to make lifestyle changes before advising weight loss. The available evidence suggests that when physicians identify obesity as a problem and advise patients to lose weight there is a greater likelihood that patients will take action. However, physicians continue to discuss this important topic with only a minority of obese patients. Developing an approach to the complete yet efficient assessment of the obese patient is the first step in helping these individuals lose weight and improve their health.

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  1. School of Medicine, Denver Health Medical Center, University of Colorado, 777 Bannock Street, Denver, CO, 80204, USA

    Daniel H. Bessesen M.D.

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  1. Department of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Robert F. Kushner

  2. Endocrinology, University of Colorado School of Medicine, Denver, Colorado, USA

    Daniel H. Bessesen

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Bessesen, D.H. (2014). Assessment of the Obese Patient. In: Kushner, R., Bessesen, D. (eds) Treatment of the Obese Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1203-2_12

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