Tools for obesity diagnosis in adults
Obesity remains underdiagnosed and undertreated.1
Only 55% of people with obesity receive a formal diagnosis, and even fewer receive long-term obesity care1
Diagnosing your patients with obesity using the following protocols recommended by AACE/ACE2:
Evaluation
- Medical history
- Physical examination
- Clinical laboratory
- Review of systems, emphasizing obesity-related complications
- Obesity history
- Chart weight vs age
- Lifestyle patterns and preferences
- Previous interventions
Anthropometric diagnosis
- Confirm elevated BMI represents excess adiposity
- Measure waist circumference to evaluate cardiometabolic disease risk
Clinical diagnosis
- Normal weight: <25 kg/m2‡
- Overweight: 25 kg/m2–29.9 kg/m2
- Obesity: ≥30 kg/m2
- Evaluate checklist of obesity-related complications
‡Or <23 kg/m2 in certain ethnicities with waist circumference below regional/ethnic cutoffs.
Risk assessment tool
This tool can help you assess the risks weight-related comorbidities pose to your patients and plan a course of action to help alleviate these conditions through long-term weight management.
BMI 32
BMI 32
BMI 31
BMI 34
Carl
Age: 36
BMI: 32 kg/m2
Prediabetes diagnosis
2 years ago, routine blood work showed Carl’s blood glucose level was within the prediabetes range.
Healthy eating and exercise can help
To improve his weight and his blood glucose level, Carl began eating healthier foods and joined a gym.
Severe pain in right knee
At his most recent yearly physical, Carl experiences sharp pain in his right knee, which has begun to limit his activities. Carl receives a diagnosis of osteoarthritis in his right knee. He is offered therapeutic and surgical options, but he has concerns about the required time and physical therapy.
This isn’t working
His BMI continues to slowly increase, his blood glucose level hasn't improved, and his knee pain has only gotten worse. Carl and his physician agree that his obesity may be what is driving his other comorbidities.
What are the next steps?
If healthier eating habits and exercise aren't enough, what other options are available to help Carl manage his weight?
Monica
Age: 41
BMI: 31 kg/m2
Expanding the family
Monica and her husband have 2 children. She gained a significant amount of weight during her 2 pregnancies and is having trouble losing weight and keeping it off.
Regularly irregular
Her menstrual cycle has never been regular, but Monica has noticed her periods have become longer and more irregular since her weight gain. After consulting with her OB/GYN, having blood tests, and an ultrasound performed, Monica is diagnosed with PCOS.
Lifestyle modification
Her OB/GYN also stressed that lifestyle modification could help with weight management.
This isn’t working
Eight months later, Monica hasn’t been able to manage her weight and continues to struggle with her PCOS symptoms. Monica and her OB/GYN agree that diet changes and exercise aren't helping her lose weight.
What are the next steps?
What other options are available to help Monica manage her weight?
Tracy
Age: 52
BMI: 34 kg/m2
Unsurprising story
Tracy has struggled with weight loss and regain for more than 2 decades. Despite her obesity, she never had any underlying comorbidities.
The inevitable happens
At her most recent checkup, she was diagnosed with dyslipidemia, prediabetes, and high blood pressure.
Race to lose weight
Reluctant to take medicines for her newly diagnosed complications, Tracy begins an aggressive lifestyle modification program of strict diet and intensive exercise.
Still doesn’t take
While Tracy reached the weight-loss goals she set with her physician, the weight slowly returned. Now she is taking several medications to manage her weight-related comorbidities.
What are the next steps?
Desperate to manage her weight and improve her comorbidities, what other options are available to Tracy?
AACE/ACE guidelines
Access clinical practice guidelines for the management of obesity.
Start the conversation
Pharmacotherapy may help some patients sustain weight loss
References
1. Kaplan LM, Golden A, Jinnett K, et al. Perceptions of barriers to effective obesity care: results from the National ACTION Study. Obesity (Silver Spring). 2018;26(1):61-69.
2. Garvey WT, Mechanick JI, Brett EM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(suppl 3):1-203.
