From the Guidelines
A comprehensive assessment for obesity should include a thorough medical history, physical examination, and laboratory tests to identify obesity-related complications and determine the impact of excess adiposity on an individual's physical and mental health, function, and quality of life. This assessment is crucial in identifying the drivers of weight gain, including medical conditions, medications, metabolism, dietary habits, and sedentary lifestyle, as well as psychological factors and family and financial circumstances 1.
The assessment should include anthropometric measures such as BMI and waist circumference, which can be used as screening tools, but relying solely on these measures can lead to underdiagnosis or overdiagnosis of obesity 1. A full medical assessment is recommended to determine the impact of excess adiposity on cardiometabolic health, physical functioning, and psychosocial outcomes 1.
Key components of the assessment include:
- Calculating BMI to determine if the individual meets the clinical definition of obesity (BMI ≥30 kg/m²)
- Measuring waist circumference to assess abdominal obesity
- Blood tests, such as fasting glucose, HbA1c, lipid profile, liver function tests, thyroid function, and possibly insulin levels
- Checking blood pressure and ordering additional tests like sleep studies if sleep apnea is suspected
- A detailed medical history to explore potential contributing factors, such as medications, family history, and lifestyle factors
The goal of the medical obesity assessment is to determine how excess or dysfunctional adiposity impacts a person's health and well-being, and to develop personalized, targeted, and effective obesity treatment and management approaches 1. This assessment is critical in identifying cardiovascular risk, which is a significant obesity-related impact and a leading cause of mortality worldwide 1.
By conducting a comprehensive assessment, healthcare professionals can work collaboratively with patients to develop a personalized treatment plan that may include lifestyle modifications, medication, or consideration of bariatric surgery options, depending on the individual's specific health profile and obesity severity 1.