Obesity in Adult
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Synopsis

Obesity refers to a body mass index (BMI) of 30 or higher (weight in kilograms divided by square of the height in meters). Obesity develops when an individual's energy intake is greater than energy expenditure, leading to excess weight gain. There are many variables that contribute to obesity, which is a disease that now affects approximately one-third of the United States' population.
Obesity affects individuals across broad demographics, but it is more prevalent in areas of low socioeconomic status in developed countries. Contributing environmental risk factors include the consumption of high-calorie foods, decreased physical activity, and poor sleep hygiene. There is likely a genetic predisposition to obesity, although in most cases there is not an obvious genetic cause.
Obesity predisposes to many chronic medical diseases including hypertension, hyperlipidemia, diabetes mellitus type 2, depression, hyperandrogenism, nonalcoholic fatty liver disease, pancreatitis, osteoarthritis, gout, and obstructive sleep apnea. Obesity also predisposes to cardiovascular diseases, which are among the leading causes of death in the United States. Obesity also increases the risk of malignancies including endometrial cancer, renal cancers, gallbladder cancer, esophageal adenocarcinomas, uterine cancer, liver cancer, colon cancer, female breast cancer, male breast cancer, ovarian cancer, gastric cancer, pancreatic carcinoma, and thyroid cancer, most of which are correlated with BMI. Obesity also increases the risk of more severe illness and complications for patients with COVID-19.
The following common skin conditions are seen more frequently in obese patients: hyperhidrosis and bromhidrosis, bacterial and candidal skin infections, onychomycosis, acne vulgaris, hirsutism, hidradenitis suppurativa, psoriasis, rosacea, androgenic alopecia, venous insufficiency, lipodermatosclerosis, and premature hair graying. Obesity may also be associated with rare skin conditions, including keratosis follicularis squamosa (Dohi), adiposis dolorosa (Dercum disease), cutis verticis gyrata, granular parakeratosis, and chronic obesity lymphedematous mucinosis.
Obesity affects individuals across broad demographics, but it is more prevalent in areas of low socioeconomic status in developed countries. Contributing environmental risk factors include the consumption of high-calorie foods, decreased physical activity, and poor sleep hygiene. There is likely a genetic predisposition to obesity, although in most cases there is not an obvious genetic cause.
Obesity predisposes to many chronic medical diseases including hypertension, hyperlipidemia, diabetes mellitus type 2, depression, hyperandrogenism, nonalcoholic fatty liver disease, pancreatitis, osteoarthritis, gout, and obstructive sleep apnea. Obesity also predisposes to cardiovascular diseases, which are among the leading causes of death in the United States. Obesity also increases the risk of malignancies including endometrial cancer, renal cancers, gallbladder cancer, esophageal adenocarcinomas, uterine cancer, liver cancer, colon cancer, female breast cancer, male breast cancer, ovarian cancer, gastric cancer, pancreatic carcinoma, and thyroid cancer, most of which are correlated with BMI. Obesity also increases the risk of more severe illness and complications for patients with COVID-19.
The following common skin conditions are seen more frequently in obese patients: hyperhidrosis and bromhidrosis, bacterial and candidal skin infections, onychomycosis, acne vulgaris, hirsutism, hidradenitis suppurativa, psoriasis, rosacea, androgenic alopecia, venous insufficiency, lipodermatosclerosis, and premature hair graying. Obesity may also be associated with rare skin conditions, including keratosis follicularis squamosa (Dohi), adiposis dolorosa (Dercum disease), cutis verticis gyrata, granular parakeratosis, and chronic obesity lymphedematous mucinosis.
Codes
ICD10CM:
E66.9 – Obesity, unspecified
SNOMEDCT:
414916001 – Obesity
E66.9 – Obesity, unspecified
SNOMEDCT:
414916001 – Obesity
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
While most causes of obesity are due to a combination of genetic and environmental exposures that lead to chronic net-positive caloric intake, underlying conditions listed below should be considered in the obese patient:
- Hypothyroidism
- Medication side effect (see drug-induced weight gain)
- Metabolic disorders (see metabolic syndrome)
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:12/15/2019
Last Updated:03/09/2022
Last Updated:03/09/2022