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Last Updated: 11/18/2013  

Obesity

Overweight and obesity are defined by BMI, which is calculated by dividing weight in kg by the square of height in meters. BMI <25 kg/m2 is normal; adults with BMI of 25-29 kg/m2 are overweight and those with BMI of 30 kg/m2 are obese.

Prevention
  • Provide counseling and preventive strategies for adults who are at risk for obesity, including those with weight gain, low activity, or family history of obesity.

Screening
  • Screen for obesity in all adults and children over age 6 by determining BMI.

Diagnosis
  • Measure BMI and look for comorbid conditions on physical exam and consider measurement of waist circumference.

  • Test for comorbidities including diabetes and hyperlipidemia in patients who are obese.

  • Consider the broad range of conditions associated with unhealthy weight.

Therapy
  • Initiate behavioral therapy with diet and exercise in overweight patients who are motivated to lose weight.

  • Consider drug therapy for patients with a BMI ≥30 kg/m2, or ≥27 kg/m2 with comorbidities such as hypertension, diabetes, or dyslipidemia.

  • Consider surgical treatment for very obese patients (BMI ≥35 kg/m2 with comorbidities or ≥40 kg/m2) in whom other measures have failed.

DOI: 10.7326/d161
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
George A. Bray, MD has been a consultant for Vivus Corporation, received grants from the NIH and USDA, and receives royalties for Obesity: Origins and Solutions. George A. Bray, MD has been a consultant for Vivus Corporation, received grants from the NIH and USDA, and receives royalties for Obesity: Origins and Solutions.
Deborah Korenstein, MD, FACP, Editor in Chief, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Richard B. Lynn, MD, FACP, Editor, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
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