Overweight and obesity: Evaluation and treatment algorithm
Overweight and obesity: Evaluation and treatment algorithm
BMI: body mass index; CVD: cardiovascular disease; BP: blood pressure. * BMI measured as kg/m2. ¶ Assess and treat obesity-related comorbidities:
Assess risk for presence of obesity-related comorbidities. Risk assessment for CVD and diabetes in a person with overweight or class I to III obesity includes history, physical examination, and clinical and laboratory assessments, including BP, fasting blood glucose, and fasting lipid panel (expert opinion). A waist circumference measurement is recommended for individuals with BMI 25 to <35 kg/m2 to provide additional information on risk. It is not necessary to measure waist circumference in patients with BMI >35 kg/m2, because the waist circumference will likely be elevated and it will add no additional risk information. The Panel recommends, by expert opinion, using the current cutpoints (>88 cm or >35 in for women and >102 cm or >40 in for men) as indicative of increased cardiometabolic risk.
Because obesity is associated with increased risk of hypertension, dyslipidemia, diabetes, and a host of other comorbidities, the clinician should assess for associated conditions. The Panel recommends by expert opinion that intensive management of CVD risk factors (hypertension, dyslipidemia, prediabetes, or diabetes) or other obesity-related medical conditions (eg, sleep apnea) be instituted if they are found, regardless of weight loss efforts.
Original figure modified for this publication. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol 2013 Nov 7. DOI: 10.1016/j.jacc.2013.11.004. Illustration used with the permission of Elsevier Inc. All rights reserved.
