II. Indications
- See Obesity for diagnostic criteria
III. Contraindications: Weight Reduction
- Temporary Exclusions
- Pregnancy
- Lactation (allowed if milk established)
- Unstable mental or medical illness
- Possible Exclusions
- Permanent Exclusions
- Anorexia Nervosa
- Terminal illness
IV. History
- History of lifetime weight changes
- Medical conditions and medications predisposing to weight gain
- Prior weight management strategies and their effectiveness?
- Prior Obesity Medication use
- Family History of Obesity and metabolic conditions
- Social history
- Substance use (Tobacco, Alcohol, Illicit Drug use)
- Behavioral health (e.g. Major Depression, Anxiety Disorder, emotional stress, Trauma, PTSD)
- Physical Activity (work, home, Exercise)
- Nutrition history
- Meals (timing, portions, content, preparation)
- Habits or disordered eating that may benefit from modification (e.g. Binge Eating)
V. Exam
- Vital Signs
- Oropharynx
- Mallampati Score (Grades 3-4 associated with Sleep Apnea)
-
General Exam
- Cardiopulmonary exam
- Skin exam
- Determine Obesity Measurements
- See Obesity Measurement
- Body Mass Index (BMI)
- Waist Circumference
- Neck circumference (best predictor of Sleep Apnea)
VI. Labs
- Fasting Lipid profile
- Chemistry panel (including Fasting Serum Glucose)
-
Thyroid Stimulating Hormone (TSH)
- Rarely the cause for weight gain
VII. Approach
- See Obesity Management
- Evaluate Comorbid Obesity Risk
- Is Patient Ready and Able to lose weight?
- Yes: Weight Reduction Protocol
- No: Prevention of Weight Gain Protocol
VIII. Resources
- Frank (1998) J Am Diet Assoc 98:S44-48 [PubMed]
- Keating (2024) Am Fam Physician 110(2): 145-56 [PubMed]
- Lyznicki (2001) Am Fam Physician 63(11):2185-96 [PubMed]
- Rippe (1998) J Am Diet Assoc 98:S9-15 [PubMed]
- Speer (1997) Phys Sportsmed 25:94-107 [PubMed]
- (1998) AOA Treatment Adult Obesity, 2nd edition
- (1998) Obesity Res 6(suppl 2):51S-209S
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| Definition (MEDLINEPLUS) |
Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active. Being obese increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds. NIH: National Institute of Diabetes and Digestive and Kidney Diseases |
| Definition (NCI_NCI-GLOSS) | A condition marked by an abnormally high, unhealthy amount of body fat. |
| Definition (NCI_CTCAE) | A disorder characterized by having a high amount of body fat. |
| Definition (NCI) | Having a high amount of body fat (body mass index [BMI] of 30 or more). |
| Definition (CSP) | excessively high accumulation of body fat or adipose tissue in relation to lean body mass; the amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits; individuals are usually at high clinical risk because of excess amount of body fat (BMI greater than 30). |
| Definition (MSH) | A status with BODY WEIGHT that is grossly above the acceptable or desirable weight, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY). |
| Concepts | Disease or Syndrome (T047) |
| MSH | D009765 |
| ICD9 | 278.00 |
| ICD10 | E66 , E66.9 |
| SnomedCT | 5476005, 154776002, 190963004, 414916001, 414915002 |
| LNC | LA6301-1 |
| English | Obesity, Obesity, unspecified, OBESITY, obesity (diagnosis), obesity, Obesity NOS, Obesity [Disease/Finding], obese, adiposity, Obesity, NOS, Obesity [Ambiguous], Obese, Obese (finding), Obesity (disorder) |
| French | OBESITE, Obésité, non précisée, Obésité |
| Portuguese | OBESIDADE, Obesidade NE, Obesidade |
| Spanish | OBESIDAD, Obesidad no especificada, obesidad (trastorno), obesidad, obeso (hallazgo), obeso, Obesidad |
| Dutch | obesitas niet-gespecificeerd, Vetzucht, niet gespecificeerd, zwaarlijvigheid, Adipositas, Vetzucht |
| German | Fettleibigkeit, unspezifisch, ADIPOSITAS, Adipositas, nicht naeher bezeichnet, Adipositas, Fettsucht, Obesitas |
| Italian | Obesità, non specificata, Obesità |
| Japanese | 肥満, 肥満、詳細不明, ﾋﾏﾝ, ﾋﾏﾝｼｮｳｻｲﾌﾒｲ |
| Swedish | Fetma |
| Czech | obezita, Obezita, blíže neurčená, Obezita, otylost |
| Finnish | Lihavuus |
| Russian | OZHIRENIE, ОЖИРЕНИЕ |
| Korean | 상세불명의 비만, 비만 |
| Polish | Otyłość |
| Hungarian | Obesitas, nem meghatározott, Obesitas |
| Croatian | Gojaznost, Pretilost |
| Norwegian | Fedme |
