Obesity
Obesity is classified by BMI -- 30 or higher, with lower Asian-population thresholds preserved as a safety-relevant qualifier -- and is now treated as a chronic disease requiring long-term management, not a personal failing, per a 2026 synthesis of contemporary obesity guidelines.
Symptoms
Obesity itself is defined by measurement rather than symptoms, but it drives measurable downstream conditions: joint pain, sleep apnea, high blood pressure, fatty liver, and metabolic changes that often improve substantially with treatment.
Causes and risk
Genetics, medications, sleep, stress, food environment, and activity level all interact -- obesity is rarely a matter of willpower alone. A primary care visit screens for the comorbidities obesity commonly travels with: hypertension, diabetes, sleep apnea, and fatty liver disease.
How it is evaluated
Beyond BMI, we assess waist circumference, blood pressure, and metabolic labs, and screen for the comorbidities that determine both urgency and treatment eligibility.
Treatment
Anti-obesity pharmacotherapy is appropriate at a BMI of 30 or higher, or 27 or higher with a weight-related comorbidity, per the 2022 AGA guideline (a strong recommendation). Bariatric surgery criteria are BMI 35 or higher, or 30 or higher with a metabolic condition. Current FDA-approved long-term medications include GLP-1 and GIP/GLP-1 receptor agonists, with expanded 2025 indications such as Zepbound for obstructive sleep apnea and Wegovy for cardiovascular risk reduction, per current FDA labeling.
When to seek care
Obesity itself is not an emergency, but its complications can be: chest pain, stroke symptoms, acute pancreatitis, or severe sleep apnea with breathing pauses warrant urgent evaluation.