II. Diagnosis: Obesity

  1. Body Mass Index (BMI in kg/m2) Grading: Non-Asian Descent
    1. BMI 25 to 30: Overweight
    2. BMI 30 to 35: Class 1 Obesity
    3. BMI 35 to 40: Class 2 Obesity
    4. BMI >40: Class 3 Obesity (Severe Obesity)
  2. Body Mass Index (BMI in kg/m2) Grading: Asian Descent
    1. BMI 23 to 27.5: Overweight
    2. BMI 27.5 to 32.5: Class 1 Obesity
    3. BMI 32.5 to 37.5: Class 2 Obesity
    4. BMI >37.5: Class 3 Obesity (Severe Obesity)
  3. Waist Circumference Overweight Criteria
    1. Female >=35 inches (>=31 in asian descent)
    2. Male >=40 inches (>=35 in asian descent)
  4. Body Fat Percent Overweight Criteria
    1. Female >= 32%
    2. Male >= 25%
  5. Prior Obesity definitions
    1. Men: 20% over estimated Ideal Weight
    2. Women: 30% over estimated Ideal Weight

III. Exam: Most useful Measurements

  1. Body Mass Index (BMI)
  2. Anthropometry
    1. Waist-to-Hip Ratio
    2. Waist Circumference
  3. Neck circumference (best predictor of Sleep Apnea)
    1. Men: >17 inch (42.5 cm) neck circumference
    2. Women: >16 inch (40.6 cm) neck circumference

IV. Exam: Other Measurements

  1. Skin-fold measurement
    1. Very operator dependent
    2. Normal subcutaneous fat
      1. Men: 11%
      2. Women: 18%
  2. Underwater weighing
    1. Gold standard
    2. Dependent on bone density
  3. Bioelectrical impedance
    1. Safe, noninvasive, fairly reliable
    2. Dependent on hydration

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