Obesity

Diagnosis

To diagnose obesity, your health care professional will conduct a thorough assessment, which includes the following evaluations:

• Health history review:
  • Weight analysis: Discuss your weight history, efforts to lose weight, and any results from previous attempts.
  • Exercise and physical activity: Talk about your exercise habits and daily physical activities.
  • Eating patterns and appetite control: Review your dietary habits, eating patterns, and how you manage your appetite.
  • Medical and medication history: Provide information on past medical conditions, current medications, and stress levels.
  • Family health history: Explore diseases and health issues in your family to assess genetic risks.
• General physical exam:
  • Vital signs: Check your heart rate, blood pressure, and temperature.
  • Heart and lungs: Listen to the functioning of your heart and lungs.
  • Abdominal examination: Conduct a thorough examination of the abdomen.
  • Height measurement: Measure your height as part of the assessment.
• Body mass index (BMI) calculation: Your BMI will be calculated to determine if it falls into the obesity category, which is a BMI of 30 or higher. A higher BMI escalates the risk of additional health complications. It’s advisable to monitor your BMI at least annually.
• Waist circumference measurement: Measure the circumference of your waist. Women with more than 35 inches and men with more than 40 inches are at an increased risk of heart disease and diabetes. Like BMI, waist circumference should also be measured annually.
• Screening for additional health issues:
  • Existing health issues: Evaluate any known health issues.
  • Potential concerns: Check for high blood pressure, high cholesterol, underactive thyroid, liver issues, and diabetes.

Collecting and analyzing this data assists your health care team in determining the most effective treatment approach for you.

Treatment

Obesity treatment aims to achieve and maintain a healthy weight, enhancing overall health and reducing the risk of obesity-related complications. Effective management typically involves a team of health professionals, including a dietitian, behavioral counselor, or obesity specialist. The initial goal is to achieve a modest weight loss of 5% to 10% of total body weight. For instance, a 200-pound individual would aim to lose 10 to 20 pounds. Achieving this can significantly improve health, with greater benefits seen with additional weight loss.

• Dietary changes
  • Calorie reduction: Reducing calorie intake is crucial. Professional guidance can help determine the daily caloric intake necessary to lose weight effectively.
  • Feeling full on fewer calories: Opt for foods like fruits and vegetables that provide larger portions for fewer calories, helping reduce hunger pangs.
  • Healthier choices: Focus on plant-based foods, lean proteins, and limit salt and added sugars. Include heart-healthy fats in moderation.
  • Meal replacements: These may involve replacing one or two meals a day with low-calorie shakes or bars to simplify calorie reduction.
• Exercise and physical activity
  • Regular exercise: At least 150 minutes of moderate-intensity activity per week is recommended for effective weight management.
  • Increasing daily movement: Simple changes like taking stairs and parking further away can help increase daily step count and overall calorie expenditure.
• Behavior changes
  • Counseling and support groups: Addressing psychological and behavioral aspects of eating through counseling or participating in support groups can be beneficial.

Medical interventions

• Weight-loss medications: These should complement diet, exercise, and behavior modifications, not replace them. Common FDA-approved medications include:
  • Bupropion-naltrexone
  • Liraglutide
  • Orlistat
  • Phentermine-topiramate
  • Semaglutide
• Endoscopic procedures: These non-surgical interventions may involve placing devices or making modifications inside the stomach to reduce food capacity.
• Bariatric surgery: Surgical options like gastric bypass, adjustable gastric banding, and gastric sleeve surgery limit food intake and, in some cases, calorie absorption.

Avoid quick-fix solutions or fad diets, as sustainable weight loss requires long-term dietary and lifestyle changes. Regular follow-up with healthcare providers is essential to adjust treatment plans and manage any associated health issues effectively.