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Obesity Management - Dr.Ravi Sankar Endocrinologist MRCP(UK) CCT - GIM (UK)

Obesity
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Weight Status Body Mass Index (BMI)
Underweight less than 18.5
Normal or Healthy Weight 18.5–24.9
Overweight greater than or equal to 25–29.9
Class I Obesity 30–34.9
Class II Obesity 35–39.9
Class III Obesity greater than or equal to 40
Morbid obesity is diagnosed when the patients meet greater than or equal to 1 of the following criteria:
greater than or equal to100 pounds over the ideal body weight
BMI greater than or equal to 40
BMI greater than or equal to 35 and health conditions related to obesity (e.g., hypertension, diabetes)

Treatment
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First-line: lifestyle modifications
Dietary changes: calorie restriction, healthy foods (e.g., fruit/vegetables, protein-rich, unsaturated fats, sodium-restricted)
Physical activity: minimum of 30 minutes moderate exercise per day (2.5 hours per week) , which increases insulin sensitivity, lowers blood pressure, and promotes weight loss
Medical therapy: treat hypertension (e.g., ACE inhibitors), diabetes mellitus, and dyslipidemia (e.g., with statins)
Bariatric surgery: if BMI ≥ 40 and no success with dietary and lifestyle changes
Sleeve gastrectomy (most common): large part of the greater curvature is removed, so that the remaining stomach resembles a sleeve
Roux-en-Y gastric bypass (2nd most common): Roux-en-Y

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