Clinical evaluation of patients living with obesity.
Laurence J DobbieClaudia CoelhoJames CraneBarbara McGowanPublished in: Internal and emergency medicine (2023)
Obesity is a significant public health concern which is implicated in cardiometabolic disease, mechanical complications and psychiatric sequelae. BMI is currently used for diagnosis; however, it has limited sensitivity for adiposity in certain circumstances. This has led to the development of risk stratification tools like the Edmonton Staging criteria and the Kings Obesity Staging Criteria: these facilitate and guide comprehensive obesity-related complication assessment. Healthcare professionals working within obesity clinics should adopt evidence-based communication strategies, including shared decision-making, motivational interviewing, and realistic goal setting. It is also vital to avoid weight-stigmatising terminology in all aspects of care, as this can negatively impact patients. Primary care plays an essential part in obesity care and should work to promptly identify cases, initiate treatment and forward on to specialist services where appropriate. Clinical evaluation of the patient living with obesity should take a holistic approach and involve input from bariatric physicians, dietitians, psychologists, and bariatric surgeons, wider members of the multi-disciplinary team should be involved where needed. Clinicians should take a detailed history, examination and order laboratory tests to investigate for complications. Overall, with appropriate evaluation, these assessments can guide patient management and facilitate long-term improvement in health.
Keyphrases
- weight loss
- insulin resistance
- weight gain
- primary care
- metabolic syndrome
- high fat diet induced
- type diabetes
- public health
- healthcare
- bariatric surgery
- palliative care
- roux en y gastric bypass
- end stage renal disease
- body mass index
- ejection fraction
- mental health
- newly diagnosed
- gastric bypass
- case report
- climate change
- prognostic factors
- lymph node
- pain management
- physical activity
- health information
- risk factors
- health insurance
- affordable care act