Evaluation and Treatment Strategy

When physicians encounter patients in the clinical setting, the opportunity exists for identifying overweight and obesity and accompanying risk factors and for initiating treatment for both the weight and the risk factors, as well as chronic diseases such as CVD and type 2 diabetes. When assessing a patient for treatment of overweight and obesity, consider the patient's weight, waist circumference, and the presence of risk factors. The strategy for the evaluation and treatment of overweight patients is presented in the Treatment Algorithm. This algorithm applies only to the assessment for overweight and obesity and subsequent decisions based on that assessment. It does not reflect any initial overall testing for other conditions and diseases that the physician may wish to do. Approaches to therapy for cholesterol disorders and hypertension are described in ATP II and JNC VI, respectively. In overweight patients, control of cardiovascular risk factors deserves equal emphasis as weight loss therapy. Reductions of risk factors will reduce the risk for cardiovascular disease whether or not efforts at weight loss are successful. The panel recognizes that the assessment for overweight and obesity may take place as part of an overall health assessment; however, for clarity, the algorithm focuses only on the evaluation and treatment of overweight and obesity. Each step (designated by a box) in the process is reviewed when you go to the Treatment Algorithm and click on the various boxes.