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.
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.
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.
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.