nutritional disorders
Obesity
Key Points
Obesity increases the risk of many common health problems and causes up to 300,000 premature deaths each year in the United States, making it second only to cigarette smoking as a preventable cause of death. Excess caloric intake and too little physical activity contribute the most to obesity, but genetic susceptibility and various disorders (including eating disorders) may also contribute. Screen patients using BMI and waist circumference and, when body composition analysis is indicated, by measuring skinfold thickness or using bioelectrical impedance analysis. Screen patients with obesity for common comorbid disorders, such as obstructive sleep apnea, diabetes, dyslipidemia, hypertension, steatotic liver disease, and depression. Encourage patients to lose even 5 to 10% of body weight by changing their diet, increasing physical activity, and using behavioral interventions if possible. Consider anti-obesity medications if BMI is ≥ 30 or if BMI is ≥ 27 with complications (eg, hypertension,insulinresistance); however, for severe obesity, surgery is most effective. Encourage all patients to exercise, to eat healthily, to get enough sleep, and to manage stress. 