Obesity

Diagnosis and
Assessment

Definition

Obesity is defined as an excess accumulation of body fat

This excess accumulation is the result of a positive

energy balance where caloric intake exceeds caloric
expenditure

It is the most common nutritional disorder in

industrialized countries and is becoming increasingly
prevalent in developing countries due to changing
lifestyles.

HISTORY

History :
Key

elements:

Eating

habits
Habitual physical activities
Family history
Psychological Status Evaluation
Obesity Linked disease
Medications (Steroid, anti psychotics)

Eating Habits
Frequency
Food Choices and calories
Snacking / Binge Eating
Abnormal eating behaviour( binging,
nocturnal eating)

Family History
Obesity
Diabetes
Hypertension
Dyslipidaemia
CVS disease ( eg: MI)
Cancer
Thyroid Disease

Others:

Cardiovascular System
Digestive System
Endocrine System
Musculoskeletal System
Nervous System
Reproductive System
Respiratory System
Urinary System
Dermatology System (Skin)
Immune System

Obesity Linked Disease

DM

II
HTN
CVD
OA
Sleep apnea.

Examination

Examination:

First impressions

WITHOUT BEING
JUDGEMENTAL!

Vital signs:

PR
RR
BP
and Temperature

General examination.

BMI
Waist Circumference
Waist Hip Ratio

Evaluation :
BMI =

weight (kg) / [ height (m) ]

Waist Hip Ratio

Key value:
WHR: > 0.90 for men
WHR : > 0.85 for women

How to do it:

Investigations

Laboratory Data:

Parameter

Normal Range

Blood glucose
Cholesterol
Triglycerides
HDL
LDL
Hemoglobin
Hematocrit
TSH
Cortisole
Serum iron
Uric acid
Hemoglobin A1c*

80-120 mg/dl
< 200 mg/dl
< 150 mg/dl
40 - 60 mg/dl
< 100 mg/dl
13-16 mg/dl
36-44%
0.35-5.50
5-25 am 3-16 pm g/dl
40-140 mg/dl
(3.5-7.8)
4.8-6.3%

Additional Tests :
ECG
x-ray
U.S

Once
Diagnosis
made:
Further
assessment should also consider:
I.

Disease:
Cardiovascular

Risk Factors and disease

Respiratory System
Endocrine
II. Identification

of Underlying aetiology