Clinical Assessment of People Living with Obesity
Key messages for healthcare professionals
- Obesity is a complex chronic disease, characterised by the excess or dysfunctional adiposity, that impairs health.
- Screening for obesity should be performed by measuring body mass index and, if indicated, waist circumference.
- The clinical assessment of obesity should establish the diagnosis and identify the causes and consequences of dysfunctional or excess adiposity on a patient’s physical, mental and functional health.
- Healthcare professionals participating in the assessment of obesity should focus on establishing values and goals of treatment, identifying which resources and tools may be needed and fostering selfefficacy with the patient for long-term management.
- A non-judgemental, stigma-free environment is necessary when undertaking assessments with a patient living with obesity.
Recommendations
- We suggest that healthcare professionals (HCPs) involved in screening, assessing and managing people living with obesity use the 5As of Obesity Management framework to initiate the discussion by asking for their permission and assessing their readiness to initiate treatment (Level 4, Grade D, Consensus).
- HCPs can measure height, weight and calculate BMI in all adults (Level 2a, Grade B)1-9, and measure waist circumference in individuals with a BMI 25 kg/m2 – 35 kg/m2 (Level 2b, Grade B)10-12.
- We suggest a comprehensive history to identify root causes of weight gain, as well as including complications of obesity and potential barriers to treatment in the assessment (Level 4, Grade D)13-15.
- We recommend blood pressure measurement in both arms, fasting glucose or glycated hemoglobin (HbA1c) and lipid profile to determine cardiometabolic risk and, where appropriate, to screen for non-alcoholic fatty liver disease and sleep-disordered breathing in people living with obesity (Level 3, Grade D)16-19.
- We suggest HCPs consider using the Edmonton Obesity Staging System to determine the severity of obesity and to guide clinical decision making (Level 4, Grade D)20,21.
Key messages for people living with obesity
- Obesity is a complex chronic disease, characterised by excess or dysfunctional body fat (adiposity), that impairs health. Obesity has a negative impact on your physical and mental health, as well as your overall quality of life.
- To guide you and your healthcare professional (HCP) on the best obesity-treatment options, a clinical assessment is needed to determine how your weight or body fat affects your health and wellbeing. This may include a physical exam, blood tests, mental health assessment and interviews and questionnaires about health and habits.
- Weight bias and obesity stigma exist for adults in healthcare settings and can be detrimental to helping you achieve your health goals. HCPs should conduct an obesity assessment in a sensitive and nonjudgemental way and use language that is respectful and inclusive22-24.
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