Evaluation of the Obese Patient

Abstract

OBESITY ranks as one of the most common medical disorders in this country. Its importance lies in its association with many common diseases that may enhance morbidity and mortality. Yet, until recently, it has been one of the least-accurately characterized. When gross endocrine or other disease can be excluded, it is often the practice to categorize patients as having "exogenous obesity." Since all obesity is exogenous with respect to energy balance, this term contributes little to the understanding of the problem and ought to be discarded. Indeed, the term exogenous obesity has acquired a connotation of blaming the patient for allowing such a condition to develop. This term implies that obesity is a simple consequence of overeating and is in turn ascribed to human frailty or to emotional instability.¹This is perhaps in part a consequence of our frustration in treating a difficult clinical problem. Rapidly expanding knowledge has