When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Obesity in adults

Last reviewed: 12 Nov 2024
Last updated: 04 Jun 2024

Summary

Definition

History and exam

Key diagnostic factors

  • height
  • weight
Full details

Other diagnostic factors

  • waist circumference
  • comorbid conditions
Full details

Risk factors

  • hypothyroidism
  • hypercortisolism
  • age ≥40 years
  • peri- and postmenopause
  • prior pregnancy
  • marital status
  • sleep deprivation
  • tobacco
  • education level
  • poor in utero nutrition
  • socioeconomic status
  • sedentary lifestyle
  • television watching or video gaming
  • diet high in sugar, cholesterol, fat, and fast food
  • heavy alcohol intake
  • binge-eating disorder
  • night eating syndrome
  • leptin deficiency
  • corticosteroid therapy
  • antidepressant therapy
  • antipsychotic therapy
  • beta-blocker therapy
  • adjuvant breast cancer therapy
  • psychiatric diagnosis
Full details

Diagnostic tests

1st tests to order

  • clinical exam
Full details

Tests to consider

  • CBC
  • serum aminotransferases
  • thyroid function tests
  • ECG
  • abdominal ultrasound scan
  • polysomnography (sleep study)
Full details

Treatment algorithm

ONGOING

BMI ≥30 kg/m²; or else BMI ≥27 kg/m² with an obesity-related comorbidity

BMI ≥35 kg/m² with or without comorbidities

Contributors

Authors

Constantine T. Frantzides, MD, PhD, FACS
Constantine T. Frantzides

Director, Chicago Institute of Minimally Invasive Surgery (CIMIS)

Director, Laparoscopic and Bariatric Fellowship Program

Clinical Professor of Surgery, University of Illinois

Chicago

IL

Disclosures

CTF declares that he has no competing interests.

Mark A. Carlson, MD, FACS
Mark A. Carlson

Professor, Department of Surgery

Professor, Department of Genetics, Cell Biology and Anatomy (courtesy)

Director, Center for Advanced Surgical Technology (CAST)

University of Nebraska Medical Center

Omaha

NE

Disclosures

MAC declares that he has no competing interests.

Kelsey R. Tieken, MD
Kelsey R. Tieken

General Surgery Resident

University of Nebraska Medical Center

Omaha

NE

Disclosures

KRT declares that she has no competing interests.

Nathan D. Bills, PhD, MBA

Associate Professor

Department of Surgery

University of Nebraska Medical Center

Omaha

NE

Disclosures

NDB declares that he has no competing interests.

Acknowledgements

Dr Constantine T. Frantzides, Dr Mark A. Carlson, Dr Kelsey R. Tieken, and Dr Nathan D. Bills would like to gratefully acknowledge Dr Minh B. Luu and Dr Scott N. Welle, previous contributors to this topic.

Disclosures

MBL and SNW declare that they have no competing interests.

Peer reviewers

Carel Le Roux, MRCP, PhD, FRCPath

Consultant in Metabolic Medicine

Imperial College London

Charing Cross Hospital

London

UK

Disclosures

CLR declares that he has no competing interests.

Arya M. Sharma, MD, PhD, FRCPC

Professor of Medicine

Chair for Obesity Research & Management

University of Alberta

Royal Alexandra Hospital

Edmonton

Canada

Disclosures

AMS declares that he has no competing interests.

Edward H. Livingston, MD, FACS

Chair in Surgery

Division of Gastrointestinal and Endocrine Surgery

University of Texas

Southwestern Medical Center

Dallas

TX

Disclosures

EHL declares that he has no competing interests.

  • Differentials

    • Hypothyroidism, primary
    • Hypothyroidism, central
    • Cushing syndrome
    More Differentials
  • Guidelines

    • 2022 ASMBS and IFSO: indications for metabolic and bariatric surgery
    • AGA clinical practice guideline on pharmacological interventions for adults with obesity
    More Guidelines
  • Patient information

    Obesity - diet and exercise

    Obesity - drugs and surgery

    More Patient information
  • Calculators

    Body Mass Index (Quetelet's index)

    More Calculators
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer