CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Obesity - Management
How should I assess for contributing factors and existing comorbidities?
History:
- Medical history:
- Enquire into medical conditions that can contribute to overweight and obesity, or complications that may arise as a result of excess weight.
- Pay particular attention to symptoms of comorbidities that might not be recognized (e.g. sleep apnoea).
- Family history (e.g. family history of overweight and obesity, and comorbidities).
- Drug history — identify medication that might cause weight gain.
- Social history (e.g. lifestyle, diet, exercise, alcohol and smoking, work and leisure activities).
Examination:
- Check blood pressure using a large arm cuff.
Investigations:
- Check blood glucose and lipid profile, preferably on a fasting sample.
- Consider other tests if appropriate on the basis of assessment findings (e.g. liver function tests, thyroid function tests).
Clarification / Additional information
- Comorbidities should be managed at the time they are identified; treatment should not be delayed until the person has lost weight [NICE, 2006b].
- Investigations can be useful in that they act as a baseline for future measurements [National Obesity Forum, 2006].
Basis for recommendation
- This recommendation is based on guidance from the National Institute for Health and Clinical Excellence on the prevention, identification, assessment, and management of overweight and obesity in adults and children [NICE, 2006b], the Department of Health care pathway for the management of overweight and obesity [DH, 2006a], guidelines from the National Obesity Forum [National Obesity Forum, 2006], and a review of obesity published in the Lancet [Haslam and James, 2005].
© NHS Institute for Innovation and Improvement