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Multimodale aanpak van obesitas bij volwassenen in de eerstelijnszorgPublished by: WORELLast published: 2024Guide de pratique clinique sur la prise en charge multimodale de l’obésité chez l’adultePublished by: WORELLast published: 2024Overgewicht en obesitas bij volwassenen in de huisartsenpraktijkPublished by: Domus Medica | SSMGLast published: 2006Surcharge pondérale et obésité chez l'adultePublished by: Domus Medica | SSMGLast published: 2006

BMI measurement

The most common method to diagnose obesity is the body mass index (BMI), defined as weight divided by height squared ([weight in kg]/[height in m]²).[1][2][3][38] The BMI is a reasonable determination of obesity in the vast majority of people, but it is not accurate in pregnancy or in people with a large amount of muscle mass (e.g., professional athletes). In addition, the BMI does not account for sex, age, or bone structure, all of which can influence the relative amount of body fat. Despite these drawbacks; however, the BMI remains the standard and usual test for the diagnosis of obesity in adults. 

Waist circumference

Elevated waist circumference (>102 cm in men and >88 cm in women) is commonly used as an indicator of risk for obesity-related disease and appears to be associated with an increased risk of hypertension, diabetes, dyslipidemia, and the metabolic syndrome.[1][8][9][10]

Laboratory evaluation and imaging

No laboratory evaluation or imaging study is necessary for the diagnosis of obesity per se. If rare, secondary causes of obesity or conditions associated with obesity are suspected, then laboratory testing, including complete blood count, serum electrolytes, serum aminotransferases, thyroid function tests, and liver function tests, may be performed. An ECG may be done if there are clinical signs suggestive of heart disease, and an abdominal ultrasound scan performed if fatty liver is suspected. Polysomnography may be ordered if obstructive sleep apnea is suspected.

Body composition tests

While some experimental methods can determine body composition, none have become simple, inexpensive, and popular enough to be put into general use. These tests include skinfold measurement, hydrodensitometry, bioelectric impedance analysis, dual-energy x-ray absorptiometry, and others.[92]

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