The diagnosis of obesity is defined by a body mass index over 30 kilograms per metre squared.

General examination

To diagnose obesity a detailed and full general examination is mandatory in the initial assessment of all patients.

Weight, height, BMI, body habitus and waist hip ratio

Baseline characteristics are essential for future comparison, and will also influence the patient's metabolic risk profile. Examination may also support or refute a possible diagnosis of Cushing's syndrome.

Cardiorespiratory status

Seeking evidence of underlying disease, for example right heart failure, functional status for exercise and suitability for surgery.


Patients with severe osteoarthritis may find exercise very difficult and benefit from orthopaedic or physiotherapy input.

Thyroid status

Seek any signs of hypothyroidism which will exacerbate obesity.

Signs of Cushing's syndrome or poylcystic ovarian syndrome

Examine carefully for signs of possible underlying Cushing's syndrome or PCOS. Most patients do not require formal screening for these conditions, unless there are positive findings on examination.