Obesity is a topic covered in the 5-Minute Clinical Consult.

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  • Obesity is the state of excess adipose tissue, frequently characterized in adults by body mass index (BMI), body weight (kg)/(body height [m2]), of ≥30 kg/m2.
  • Obesity is associated with negative health outcomes (1), and the concurrent presence of abdominal obesity increases the risk of morbidity and mortality.
  • System(s) affected: endocrine/metabolic, cardiac, respiratory, gastrointestinal, musculoskeletal, dermatologic, mental health
  • Synonym(s): overweight; adiposity

Geriatric Considerations
Note: Underweight BMI (≤18) is associated with an increased risk of mortality. The most likely explanation is that this is a secondary effect; severe chronic conditions can cause anorexia and weight loss.


  • Predominant age: Incidence rises in the early 20s.
  • Predominant sex: female > male

  • Mean prevalence of obesity among adults is 35% in the United States (2,3).
  • Overweight: 40% of men and 25% of women
  • Obese: 20% of men and 25% of women
Pediatric Considerations
  • Pediatric obesity is defined as have a BMI at ≥95th percentile, as by age and sex specific WHO or CDC growth curves.
  • Obesity during adolescence and young adulthood is strongly associated with obesity in adulthood.

Etiology and Pathophysiology

  • Obesity is caused by an imbalance among food intake, absorption, and energy expenditure.
  • Underlying organic causes include psychiatric disturbances, hypothyroidism, hypothalamic disorders, insulinoma, and Cushing syndrome.
  • Medications can contribute to obesity, including corticosteroids, neuroleptics (particularly atypical antipsychotics), and antidepressants.

  • Genetic syndromes such as Prader-Willi and Bardet-Biedl are found in a minority of people with obesity.
  • Studies are insufficiently powered to isolate specific genes as independent predictors of obesity.

Risk Factors

  • Parental obesity
  • Sedentary lifestyle
  • Consumption of calorie-dense food
  • Low socioeconomic status
  • >2 hours per day of television viewing

General Prevention

  • Encourage at least 1 hour of daily exercise, limited television viewing, and moderation in portion size.
  • Avoid calorie-dense and nutrient-poor foods such as sweetened beverages and processed foods.

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