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Chapter 075. Evaluation and Management of Obesity

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Over 66% of U.S. adults are currently categorized as overweight or obese, and the prevalence of obesity is increasing rapidly throughout most of the industrialized world. Based on statistics from the World Health Organization, overweight and obesity may soon replace more traditional public health concerns such as undernutrition and infectious diseases as the most significant contributors to ill health. Children and adolescents are also becoming more obese, indicating that the current trends will accelerate over time. Obesity is associated with an increased risk of multiple health problems, including hypertension, type 2 diabetes, dyslipidemia, degenerative joint disease, and some malignancies. . | Chapter 075. Evaluation and Management of Obesity Over 66 of U.S. adults are currently categorized as overweight or obese and the prevalence of obesity is increasing rapidly throughout most of the industrialized world. Based on statistics from the World Health Organization overweight and obesity may soon replace more traditional public health concerns such as undernutrition and infectious diseases as the most significant contributors to ill health. Children and adolescents are also becoming more obese indicating that the current trends will accelerate over time. Obesity is associated with an increased risk of multiple health problems including hypertension type 2 diabetes dyslipidemia degenerative joint disease and some malignancies. Thus it is important for physicians to routinely identify evaluate and treat patients for obesity and associated comorbid conditions. Evaluation The U.S. Preventive Services Task Force recommends that physicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss. This recommendation is consistent with previously released guidelines from the National Heart Lung and Blood Institute NHLBI and a number of medical societies. The five main steps in the evaluation of obesity are described below and include 1 focused obesity-related history 2 physical examination to determine the degree and type of obesity 3 comorbid conditions 4 fitness level and 5 the patient s readiness to adopt lifestyle changes. The Obesity-Focused History Information from the history should address the following six questions What factors contribute to the patient s obesity How is the obesity affecting the patient s health What is the patient s level of risk from obesity What are the patient s goals and expectations Is the patient motivated to begin a weight management program What kind of help does the patient need Although the vast majority of obesity can be attributed to behavioral .

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