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You are here : 3-RX.com > Medical Encyclopedia > Diseases and Conditions > Obesity: Diagnosis & Tests
      Category : Health Centers > Weight Control and Management


Obesity | Symptoms & Signs | Diagnosis & Tests | Prevention & Expectations | Treatment & Monitoring

How is the condition diagnosed?

Diagnosis of obesity begins with a medical history and physical exam. The National Institute of Health, or NIH, recommends that healthcare providers follow these steps:

  • measure height and weight
  • determine the person's body mass index
  • measure waist circumference
  • assess comorbidities, or additional risk factors
  • use the treatment algorithm to see if the person should be treated for obesity
  • determine whether the person is ready and motivated to lose weight
  • Waist circumference

    The amount of fat around the abdomen is very important in assessing disease risk. An individual's risk for certain disorders increases when waist circumference is larger than normal. These disorders include the following:

  • coronary heart disease
  • high blood pressure
  • type 2 diabetes
  • A waist measurement of more than 40 inches, or 102 cm, in men and more than 35 inches, or 88 cm, in women is above normal. Combined with overweight or obesity, a high waist circumference can raise the person's disease risks from high to extremely high.


    Some disorders place a person at high absolute risk for death if they are combined with obesity. An obese person with one or more of these factors should be treated aggressively. These factors include:

  • atherosclerotic diseases, such as peripheral arterial disease and carotid artery disease that causes symptoms
  • coronary artery disease, including a history of heart attack or heart bypass surgery
  • sleep apnea
  • type 2 diabetes
  • Other comorbidities increase an obese person's risk of death but are not life-threatening. These factors, which should be treated, include:

  • gallstones
  • gynecological problems, such as amenorrhea
  • osteoarthritis
  • stress incontinence
  • A third set of comorbidities also increases an obese person's risk of death if they are combined. Three or more of these factors increase a person's high absolute risk:

  • an age of 45 or older in men
  • an age of 55 or older in women
  • cigarette smoking
  • family history of early heart disease
  • high blood pressure, or current treatment with medicines to lower blood pressure
  • high LDL cholesterol, which is the bad carrier for cholesterol
  • impaired fasting blood glucose levels
  • low HDL cholesterol, which is the good carrier for cholesterol
  • Treatment algorithm

    The treatment algorithm developed by NIH helps the provider decide if treatment for obesity is appropriate. It takes into account the person's BMI, waist circumference, and comorbidities.

    Readiness and motivation

    The healthcare provider will also ask questions to see if the person is ready and motivated to lose weight. These questions deal with the following issues:

  • attitudes toward physical activity
  • potential barriers to the person's adoption of change
  • previous attempts at weight loss
  • reasons and motivation for weight loss
  • support expected from family and friends
  • time availability
  • understanding of risk and benefits

  • Previous section


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    Obesity: Symptoms & Signs


    Obesity: Prevention & Expectations

    Author: Dr. Karen Wolfe, MBBS, MA
    Reviewer: Eileen McLaughlin, RN, BSN
    Date Reviewed: 07/03/01

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