ABSTRACT

Obesity is a disease that is difficult to treat successfully; therefore, doctors who cannot help their obese patients to become slim may turn to blaming the patient for the failure. The bariatric history has unique aspects that enable the bariatrician to identify underlying comorbidities and to develop an individualized treatment plan to optimize the patient’s likelihood of success. The abdomen of an overweight patient may have a large panniculus that overhangs the belly and pubic areas. Many obese patients have poorly healing ulcers and scars on the lower legs, with atrophic and unhealthy skin that is thin, shiny, and has a great deal of darker pigmentation. The chapter discusses the special considerations concerning the evaluation of an obese patient. They include proper blood pressure measurement techniques, estimation of the extent of the obesity problem in each patient, an electrocardiogram, and laboratory work to tailor treatment.