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Obesity: Diagnosis and investigations in obesity

Obesity occurs when your body consumes more calories than it burns. Accurate diagnosis of obesity (serious overweight) is of paramount importance for the physician and also the patient. Thanks to the collected information, the doctor is able to draw up a specific treatment plan. The patient receives information with regard to the weight he has to lose and he also knows through the tests which disorders he suffers or which complications are possibly caused by the persistent obesity. The diagnosis of obesity consists of an extensive interview, determining the BMI, measuring the waist circumference, a physical examination and a diagnostic examination.


Interview with people with obesity


Most people with severe obesity experience problems with weight or repeated failure in achieving sustained weight loss. The doctor asks several questions to the obese person, for example regarding the diet, the level of activity, the use of medication , the (history of) disorders, the weight loss efforts, ... A good interview is important to exclude serious or untreated depression . A depression may in fact be a consequence of obesity, or is sometimes the cause of the disorder. Approximately 30% of people with obesity have eating disordersand that's why the doctor also asks about this during the conversation. Furthermore, the doctor informs about other possible signs of obesity such as binge eating, purging (self-induced vomiting ), a lack of satiety, food search behavior, nocturnal eating and other abnormal dietary habits. It is important to be aware of these habits in order to be able to deal with them successfully.


Determine body fat


Determining the BMI and measuring the waist circumference and the waist-to-hip ratio are the general measurements of the degree of body fat.


BMI = body mass index

The degree of obesity can be assessed by determining the BMI. BMI stands for 'body mass index', also known as the quetelet index. This is the body weight in kg, divided by the square of the length in meters (G: L2). A man weighing 106 kg with a length of 172 cm consequently has a BMI of 106 / 1.72 * 1.72 = 35.8, which is clearly a sign of serious overweight.


Measuring waist circumference

Abdominal fat (fat stored around the waist) increases the risk of diseases, such as diabetes mellitus (diabetes) and heart disease . Women with a waist size (circumference) of more than 80 centimeters and men with a waist of more than 102 cm are more likely to experience complications due to obesity than people with a smaller waist circumference.


Classification of obesity

Obesity occurs at a body mass index that is greater than 30 kg / m2. Doctors use the following body mass index (BMI) classification to classify severe overweight and the associated risk of co-morbidity:

Overweight 25-30 Mildly increased risk

Obese > 30 Between mild and moderate risk

Class I 30-35 Moderate risk

Class II 35-40 Serious risk

Class III > 40 Very serious risk


Physical examination in persons with obesity


In a general physical exam the doctor measures the length, checks the vital functions (heartbeat, blood pressure and temperature) he listens to the heart and the lungs ( auscultation ) and examines the abdomen. Obesity implies an excessive storage of fat, and this is easiest to detect by looking at an undressed person. Furthermore, the doctor looks at the skin to determine skin problems. The doctor also touches the abdomen to exclude a liver enlargement (hepatomegaly). Finally, the doctor looks at the limbs and looks for possible signs that are related to severe obesity.


Diagnostic research in obese people

The doctor also carries out extensive blood tests to test liver function, kidney function, thyroid function, blood fat, fasting glucose and hemoglobin levels.

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