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2yr
Diagnosing obesity in your patients

Despite its increasing prevalence, obesity is one of the most misunderstood conditions in medicine. In fact, the AMA didn’t recognize it as a disease until 2013! In the United States, there are an estimated 30 million adults with diabetes, and 100 million adults with obesity. Obesity increases health risks and is associated with more than 60 comorbidities.

Physicians are key to the diagnosis of obesity, nevertheless studies show that only 55% of patients with obesity who seek treatment are diagnosed with this condition. Two key criteria for diagnosis include BMI ≥ 30 and sex-specific waist circumference (>40 inches in men; >35 inches in women).

When assessing waist circumference, be sure to take the following steps:

  1. Place the tape measure horizontally around the patient’s waist (i.e., between the lowest rib and the top of the hip bone); the umbilicus (i.e., belly button); or at the narrowest point of the midsection.
  2. Maintain a snug fit around the patient’s waist without pressing the skin and have the patient take a deep breath and exhale.
  3. Measure the waist circumference on exhalation.

Which of your patients do you evaluate for obesity? What measures do you use to diagnose obesity, and who takes these measures?

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  • 2yr
    All patients get weight checked at each clinic appointment. BMI is automatically calculated in the EMR. Nutrition or dietary consultations are available.
  • 2yr
    I weight patient with all visits. Must of my patients are Spanish so obesity is a big issueI reinforce diet, exercise. If morbid obesity I refer patients for bariatric surgery and if they are diabetic I prescribed GLP1 and it work
  • 2yr
    BMI is calculated by the EMR once the vital signs of height and weight are entered. I use it as a guide for assessing weight goals taking into account the physical status of the patient as well as lab / imaging findings to suggest fatty liver or metabolic syndrome.
  • 2yr
    All patients are evaluated (except newborns) for obesity. Height and weight and BMI are noted. Many people do not want to discuss it however, and some even refuse to be weighed nowadays. This is a major problem that is going to be with us for a very long time.
  • 2yr
    All patients have height and weight checked at each visit. Everyone is screened for obesity. BMI is auto-calculated. Diagnosis needs to be entered manually. Waist to hip ratio seems most helpful for muscular individuals. Weight loss and obesity are very frequent topics of discussion now, especially with the increased use of GLP-1 medications.
  • 2yr
    I evaluate everyone's risk factor and comorbidities associated with obesity ie: hypertension, DM, chronic renal disease, and social issues: sedentary lifestyle. I use BMI and clinical parameter to identify obese patients.
  • 2yr
    All patients have ht and wt done at each visit. BMI is used exclusively for diagnosis. Differentiating obesity from morbid obesity is important for hierarchical coding. Publicity associated with new medications make discussions easier.
  • 2yr
    All patients have ht and wt done at each visit. BMI is used exclusively for diagnosis. Differentiating obesity from morbid obesity is important for hierarchical coding. Publicity associated with new medications make discussions easier.
  • 2yr
    All of our patients have a BMI done at each visit. The height and weight are obtained by the MA, LPN, or MD, and the EMR calculates the BMI. I admit I only occasionally measure waist circumference. With the publicity the GLP-1 RAs have gotten recently, patients are much more open to discussing obesity and often initiate the conversation themseleves.
  • 2yr
    All are checked…I use BMI and weight
  • 2yr
    All who enter checked for their BMI by the MA
  • 2yr
    Any patient that is been seen in the office , gets a BMI done , usually the medical assistant or nurse check that
  • 2yr
    all patients who come though our door
    part of the physical or follow examination is BMI calculation based on height and weight measured at the office
  • 3yr
    BMI is calculated by emr . Diagnosis has to be entered manually. Have not found waist circumference documentation to be too helpful but would take into account those with more muscle mass.
  • 3yr
    Every patient in my practice gets evaluated for Obesity as weight /BMI recored along with the other vital signs on every encounter so gives a good idea about the weight gain over course of time , do take in to account the Lean Muscle mass in athletes and the body buliders where BMI Can be misleading , having taken in to account the BMI I also pay attention to the Waist to Hip ratio which is a much more significant predictor for the CV disease and is more important in the individuals who are not obese and in the above discussion is the correct way of measuring the waist , Medical assitant in my office reocrd these measures and are well trained in doing so ! When looking in to the waist circumference truncal obesity( fat in the paracolic gutters ) needs to be differntialed from the "love handles Subcutaneous fat as the protruded round belly seen in truncal obesity is the one whcih corresponds to the Increased CV risk as compared to the Subcutaneous fat seen laterally as "love handles "
  • 3yr
    Mostly BMI calculated by EMR and waist circumference for diagnosis of Metabolic syndrome to help patient understand there CVD risk .
  • 3yr
    All with BMI, weight, height by myself or MA. Our weight management clinic dieitician does waist circumference measurements and bioelectrical impedence.
  • 3yr
    This is an extremely important topic. I believe every patient should be screened for overweight and obesity. I feel so strongly about it I wrote an article about it! %3A-Predictors-of-Family-Physicians-Cyr-Haskins/13cb0452500e6c55f4d6123b851f06c849e14f3b
  • 3yr
    All patients are evaluated for obesity, the medical assistant takes the vitals, weight, height than the bmi is calculated.
  • 3yr
    Our EMR auto-calculated BMI. I use BMI as another marker to diagnose obesity using the height and weight captured in triage. Nearly all patients with an elevated BMI have obesity discussions.

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