Obesity screening-BMI, waist circumference. Barrier to screening- stigma
Abdominal adiposity not captured in BMI. Abdominal obesity increases risk of heart disease, diabetes, HTN, dyslipidemia and metabolic dysfunction.
BMI;
Underweight less than 18.5
Normal weight 18.5 – 24.9
Overweight 25.0 – 29.9 candidates for weight loss
Obesity class I 30 – 34.9
Obesity class II 35-39.9
Obesity class III 40+
It’s associated with increased morbidity(DM, HTN, dyslipidemia, heart disease, stroke, sleep apnea and cancer) and mortality.
Medications associated with increase in weight;
- Insulin
- Sulfonylureas
- Antipsychotics
- Thiazolidinediones
- Glucocorticoids
;
Secondary causes of weight gain;
- Hypothyroidism
- Cushing’s syndrome
- Acne
- Hirsutism
Management;
- Dietary habits
- Physical activity
- Medications such as duromine
Not every drug works for every patient. When maximum therapeutic effect is achieved, weight loss plateaus or creases. Efficacy of treatment is defined by loss of 4-5% of baseline weight after three months on therapeutic dose medications and is maintained at this level.
