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Description of Conditions
KEY POINTS:
Obtaining History of Weight-Related Metabolic and
Biomechanical Complications
1. Adiposopathy, or "sick fat," refers to dysfunctional adipose tissue
that contributes to metabolic diseases, including type 2 diabetes,
high blood pressure, and cardiovascular disease.
2. Fat mass disease refers to the negative health effects of excess
adipose tissue effecting body systems including joint stress,
airway compression, and/or organ compression.
3. Many complications of obesity have traditionally been attributed
to either "sick fat" or "fat mass" disease. However, emerging
evidence shows that these processes are closely interconnected
and often co-occur.
4. Chronic, low-grade inflammation is a pervasive pathophysiologic
mechanism in almost all complications of obesity.
5. Adiposopathy can contribute to increased pain, which may lead
to greater functional disability.
6. Excess adipose tissue may obscure typical physical examination
findings in complications that present as masses. When obtaining
a history of weight-related conditions, a thorough review of
systems should be conducted to identify these conditions.
7. Screening for complications and comorbidities in patients with
obesity does not differ from that for patients without obesity;
however, clinicians should remain alert for atypical presentations
of weight-related complications.
8. A thorough history should include current and past symptoms,
weight trajectory, mental health conditions, and functional
limitations.
