Obesity is an excess of body fat significant enough to affect health, and it drives diabetes, high blood pressure, fatty liver, joint disease and sleep apnoea. Central weight around the abdomen matters more than the number on the scale.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Increasing waist circumference and difficulty with previously comfortable clothing
- Breathlessness on climbing stairs or walking uphill
- Knee, hip and low back pain
- Snoring, disturbed sleep and daytime sleepiness
- Excessive sweating and skin folds that become infected
- Reduced stamina and low mood
When to see a doctor
Do not wait these outIf any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Rapid unexplained weight gain, especially with swelling or menstrual change
- Weight with breathlessness, chest pain or loud snoring with pauses in breathing
- Weight gain in a child that is affecting activity or self-esteem
- Before starting any weight-loss medication or slimming programme
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Body mass index and waist circumference
- Fasting blood sugar and HbA1c
- Lipid profile and liver function tests
- Thyroid function tests
- Ultrasound of the abdomen for fatty liver
- Blood pressure assessment and, where snoring is prominent, a sleep study referral
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- A realistic calorie deficit built on portion control, reduced fried food, sugar and refined carbohydrate
- Regular activity — a target of 150 minutes a week of brisk walking, built up gradually
- Treating contributing conditions such as hypothyroidism and PCOS
- Behavioural support, sleep correction and stress management
- Medication or bariatric surgery referral in selected patients where lifestyle measures have failed
This page is general information, not a diagnosisObesity can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the General Medicine department. If a symptom is sudden or severe, call 9281862028.