Obesity Assessment

Obesity is a chronic, progressive and relapsing disease, characterized by the presence of abnormal or excess adiposity that impairs health and social well-being.
Screening for obesity should be performed regularly by measuring body mass index (BMI) and waist circumference.
The clinical assessment of obesity should aim to establish the diagnosis and identify the causes and consequences of abnormal or excess adiposity on a patient’s physical, mental and functional health.
Providers participating in the assessment of obesity should focus on establishing values and goals of treatment, identifying which resources and tools may be needed and fostering self-efficacy with the patient in order to achieve long-term success.
A non-judgmental, stigma-free environment is necessary for an effective assessment of a patient living with obesity.

We suggest that healthcare providers involved in screening, assessing and managing people living with obesity use the 5As framework to initiate the discussion by asking for their permission and assessing their readiness to initiate treatment (Level 4, Grade D, Consensus).
Healthcare providers can measure height, weight and calculate Body Mass Index (BMI) in all adults (Level 2a, Grade B), and measure waist circumference in individuals with a BMI 25–35 kg/m² (Level 2b, Grade B).
We suggest a comprehensive history to identify root causes of weight gain as well as complications of obesity and potential barriers to treatment be included in the assessment (Level 4, Grade D).
We recommend blood pressure measurement in both arms, fasting glucose or glycated hemoglobin and lipid profile to determine cardiometabolic risk and, where appropriate, ALT to screen for nonalcoholic fatty liver disease in people living with obesity (Level 3, Grade D).
We suggest providers consider using the Edmonton Obesity Staging System to determine the severity of obesity and to guide clinical decision making (Level 4, Grade D).

Obesity is a chronic disease characterized by the accumulation of excess body fat that can have a negative impact on your physical and mental health, as well as your overall quality of life.
To guide you and your clinician on the best obesity treatment options, a clinical evaluation is needed to determine how your weight impacts your health and wellbeing. This may include both a mental health assessment and a physical exam.
Weight bias and stigma are common in the setting and can be detrimental to helping you achieve your health goals. Healthcare providers should conduct their obesity assessment in a sensitive and non-judgmental way.