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Chronic Disease of Obesity - Obesity Algorithm 2024

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8 Evaluation TOP 10 TAKEAWAY MESSAGES: Obesity Evaluation 1. Patients with obesity often do not receive standard preventive medical care. 2. Useful nutrition monitoring approaches include recording food and beverage intake using a diary. 3. Body systems to be evaluated before prescribing a physical activity program include cardiac, pulmonary, and neuro- musculoskeletal systems, as well as metabolic processes (diabetes mellitus, hypertension). 4. Routine laboratory assessment may include measures of glycemia (fasting glucose levels, hemoglobin A1c [HbA1c]), lipid levels, liver enzymes, electrolytes, creatinine and blood urea nitrogen, thyroid stimulating hormone (TSH), complete blood count (CBC), urine for albumin, and possibly vitamin D. 5. Individual testing may include evaluation for insulin resistance, insulinoma or nesidioblastosis, hypercortisolism, oligomenorrhea/ amenorrhea, hyperandrogenemia and polycystic ovary syndrome in women, and hypogonadism in men. 6. Other diagnostic tests in patients with overweight or obesity might include magnetic-resonance imaging or computed tomography (CT) of the pituitary, resting electrocardiogram (EKG), cardiac stress testing, echocardiogram, coronary calcium scores, ankle-brachial index, sleep studies, and imaging studies of the liver. 7. Methods to measure body composition include dual-energy x-ray absorptiometry (DXA), bioelectrical impedance, whole-body air displacement plethysmography (BOD POD), measuring tape, or skinfold calipers. 8. Prader-Willi is the most common non-inherited, non-polygenic genetic syndrome that may promote obesity. 9. MC4R deficiency (autosomal dominant or recessive) is the most common inherited, non-polygenetic syndrome that may promote obesity. 10. Medical conditions that may promote fat mass gain include hypothalamic damage, immobility, insulinoma, hypercortisolism, sleep disorders, untreated hypothyroidism, and adverse effects of concurrent medications.

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