DIAGNOSIS CHECKLIST
for Obesity

Why: the onset of obesity may occur at any age.

Why: If male should consider Klinefelter's syndrome. If female should consider polycystic ovarian syndrome.

Why: If the person is a child, must consider the rare congenital disorders that cause obesity such as Prader-Willi, Laurence-Moon-Bardet-Biedl syndrome or Beckwirth-Wiedemann syndrome. Studies have found that 10% of prepubertal and 15% of adolescent child age groups are obese. Medical causes of obesity in children are rare.

Why: obesity is influenced by environmental and genetic factors.

Why: these problems can stimulate overeating and comfort eating.

Why: e.g. family tendency, female sex, lack of physical exercise, emotional deprivation, depression, poorer social classes, alcohol abuse, cessation of smoking, tricyclic antidepressants.

Why: e.g. Hypothyroidism may be associated with previous Graves disease, Rheumatoid arthritis, Down Syndrome, previous radioactive ablation of the thyroid; Encephalitis may cause injury to the hypothalamus result in excessive appetite and obesity.

Why: e.g. corticosteroids may cause a Cushing-like appearance; hypothyroidism may be caused by lithium or amiodarone; medications that may cause weight gain include the tricyclic antidepressants, steroids, pizotifen, thioridazine and the contraceptive pill.

Why: The outstanding cause of weight gain is excessive calorie intake coupled with lack of exercise. People with obesity often deny overeating but the true situation can be determined by recording actual food and beverage intake and energy expenditure, and be interviewing a reliable witness.

Why: The outstanding cause of weight gain is excessive calorie intake coupled with lack of exercise. People with obesity often deny overeating but the true situation can be determined by recording actual food and beverage intake and energy expenditure, and be interviewing a reliable witness.

Why: excess alcohol consumption may cause a excess weight and may cause a Cushing-like appearance (pseudo-Cushing's syndrome).

Why: must consider the possibility of an insulinoma or Frohlich's syndrome (also have poorly developed genitals).

Why: the presence of mental retardation with obesity should suggest Laurence-Moon-Bardet-Biedl syndrome or Prader-Willi syndrome.

Why: may suggest a variety of tumors including craniopharyngioma, optic glioma and pituitary tumors that may cause injury to the hypothalamus and result in excessive appetite and obesity.

Why: may suggest angina which may be a consequence of obesity.

Why: Obesity may cause a variety of bone and joint disturbances, including low back pain and aggravation of osteoarthritis, particularly of the knees and ankles.

Why: e.g. frequency of urination, excessive thirst, tiredness, fatigue, increased infections especially of the skin and genitals, blurry vision. Obesity is a major risk factor for diabetes mellitus type 2.

Why: e.g. staphylococcal skin infections, tingling or numbness of the feet, impotence, heart attack, intermittent claudication due to peripheral vascular disease - these complications may be the presenting features of diabetes.

Why: e.g. unexplained weight gain especially central abdominal, change of appearance, moon-like face, thin skin, easy bruising, excessive facial hair growth, acne, muscle weakness, lack of or rare menstrual periods, poor libido, depression, psychosis, insomnia, frequent urination, excessive thirst, growth arrest in children.

Why: e.g. lethargy, unexplained weight gain, constipation, puffiness of face and eyes, hair loss, dry skin. Hypothyroidism is not usually associated with marked obesity.

Why: e.g. excessive growth of hands, feet, nose, lips, face, jaw and tongue; weakness, sweating, headaches, loss of menstrual periods in females, reduced libido in males.

Why: e.g. symptoms occur with fasting and are relieved by ingestion of carbohydrates and may include headache, confusion, visual disturbances, muscle weakness, lack of co-ordination, change in personality, faintness, weakness, tremor, palpitations, sweating, hunger and nervousness.

Why: e.g. depressed mood, crying spells, anhedonia (loss of interest or pleasure), increase or decrease in appetite (usually decreased), weight loss or gain, insomnia or increased sleeping (usually early morning waking), fatigue, loss of energy, feelings of worthlessness, feelings of excessive guilt, poor concentration, difficulty making decisions, low libido, thoughts of death or suicide attempt. Overeating may be a feature of depression, especially in the early stages.

Why: e.g. loud snoring, daytime sleepiness and fatigue, unrefreshed sleep, restless sleep, morning headache, nocturnal choking, reduced libido. Obstructive sleep apnea is often a consequence of obesity.

Why: e.g. acne, infrequent or absent menstrual periods, excessive hairiness, obesity.

Why: e.g. only affects males, excessive growth of the long bones of the arms and legs. The boys are tall and slim but without testosterone treatment they become obese as adults.

Why: e.g. congenital disorder with characteristic features of obesity, mental retardation, webbing or fusing of fingers or toes, extra fingers or toes, small genitals, visual problems.

Why: e.g. congenital disorder with characteristic features of bizarre eating habits (such as binge eating), obesity, lack of muscle tone in the limbs, small genitals, mental retardation, small hands, small feet, narrow forehead, "almond-shaped" eyes, "tented" upper lip.

Why: e.g. congenital disorder with characteristic features of obesity, excessive growth, large head, large tongue, hernia around the umbilicus. Intelligence is in the normal range.