Obesity in adults - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Presentation of obesity may range from asymptomatic to presentation complicated by multiple comorbidities, including cancer, coronary artery disease, diabetes, hypertension, gout, obstructive sleep apnea, and osteoarthritis. Worldwide, it is estimated that nearly 4 million people die each year as a consequence of weight-related comorbidities.
The definitive test for obesity remains the body mass index (BMI; obesity is defined as a BMI ≥30 kg/m²).
Central or abdominal obesity has a stronger association with obesity-related comorbidity than peripheral (i.e., subcutaneous) obesity, so waist circumference may be a better indicator of the risk for obesity-related comorbidity than BMI.
The mainstay of nonsurgical treatment of obesity is diet and exercise, with psychological therapy as a recommended adjunct for all patients. However, the overall efficacy and durability of this combination is poor, and the management of obesity is evolving with new pharmacologic options and improved surgical outcomes.
Pharmacotherapy may be considered as an adjunct to diet and exercise (preferably not as monotherapy) for patients with a BMI ≥30 kg/m².

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Jensen MD, Ryan DH, Apovian CM, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014 Jun 24;129(25 suppl 2):S102-38.[Abstract][Full Text]
Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020 Dec;54(24):1451-62.[Abstract][Full Text]
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 Jul;22 Suppl 3:1-203.[Abstract][Full Text]
National Institute for Health and Care Excellence. Obesity: identification, assessment and management. September 2022 [internet publication].[Full Text]
American Society for Metabolic and Bariatric Surgery. Metabolic and bariatric surgery fact sheet. July 2021 [internet publication].[Full Text]

Other Online Resources

WHO: GHO Data Repository: obesity

Referenced Articles

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