Weight is a measure of mass and changes in weight can indicate medical issues. Weight gain occurs when caloric intake exceeds expenditure, leading to increased body fat and health risks. Weight can help identify disorders of various body systems. Body shape is also important, as apple-shaped bodies with central obesity carry higher disease risks than pear-shaped bodies. Body mass index and new measures like body volume index are used to assess obesity levels and health risks. A full assessment of weight issues considers diet, exercise, medications, medical history and other relevant factors.

2. Weight is a body’s relative mass or quantity of matter
contained by it.
Weight gain or loss are very good indicators of medical
diseases and must be considered as a diagnostic
criteria of great importance.
Weight changes result from changes in body tissue and
fluid while weight gain is when caloric intake exceeds
expenditure resulting in increased body fat and
consequently increased health risk factors.
Weight can help identify disorders involving all systems
of the body (cardiovascular, gastrointestinal,
respiratory, psychiatric, etc.).

3. Body shape and Fat
distribution:
Most people are have either an apple-shaped body or a pear-
shaped body, but there are many other different body shapes.
Obesity in Apple-shaped patients tend to have higher risk of
associated diseases than pear-shaped patients and is called
central obesity and important for BVI.

5. How to assess obesity by using
BMI (body mass index):
Body mass index is a measure of body fat and is
used to categorize if a person is underweight,
normal, overweight or obese. People with increased
BMI have increased health risk factors.

6. How to assess obesity by using
BVI (body volume index):
 Is a new application for the measurement of obesity:
 Looks at relationship between mass and volume distribution(fat
distribution on different parts of body) since there are people of
different age, ethnicity, and body shapes.
 It automatically measures BMI, waist circumference, and waist-hip
ratio in addition to 3D volumetric and body composition analysis.
 Assigned to people with same BMI but different body shape and
weight distribution.

8. Checking for weight by scale, measure height, and
compare and identify if they are proportionate.

9. It is important to ask the
patient about any weight
loss or gain throughout the
years and throughout the
past few months, how does
the patient feel about his or
her weight or image, what is
the weight of other close
family members.

10. assessing dietary
intake including
sodium intake, water
intake, physical
exercise, does the
patient eat more while
stressed, in general
when does the patient
eat more or less, and
in which occasions.

11. Easy
checking of
dietary intake
is done by a
rapid screen
for dietary
intake and
nutrition
screening list:

12. Does the patient take any drugs associated
with weight gain such as tricyclic anti-
depressants, contraceptives, and
glucorticoids, or associated with weight
loss such as anti-depressants, levodopa,
and anticonvulsants.
Has the patient increased in weight after
pregnancy, is there any alcohol, cocaine, or
drug abuse which is associated with weight
loss, smoking cigarettes decreases appetite.

13. Does the patient avoid certain food or beverage
because of religious views or particular diseases
such as hypercholesterolemia or diabetes.
Assess the patients age, financial status since it
may affect food intake and nutrition.
Who shops or cooks for the patient, does the
patient have the ability to move freely or is
disabled, is there any emotional or mental
impairment, is there lack of teeth or cavities.
Malnutrition should be noticed with fatigue,
weakness, ankle swelling, flaky dermatitis, and cold
intolerance.
Check for distribution of fat and body shape, if it’s
generalised then its simple obesity but if there is
truncal fat with thin limbs then it’s Cushing's
syndrome or metabolic syndrome.

14. Unhealthy diet (excessive intake of fat and
carbohydrates)
Inactivity
Pregnancy
Lack of sleep
Certain medications
Endocrine disorders (hypothyroidism or
Cushing's syndrome)
Few due to genetics (leptin) or psychiatric
illness

15. Heart disease
Liver problems (fatty liver)
Obstructive sleep apnoea
Certain types of cancer
Osteoarthritis
Asthma
Metabolic syndrome

16.  Patient refuses to maintain normally body
weight with a BMI less than 17.5, feels fat
although underweight, starving but in denial,
associated with depression, self-induced
vomiting, excessive training, bradycardia,
hypotension, amenorrhea, dry skin and dental
caries.

17. Repeated binge eating followed by self-
induced vomiting, excessive exercise
and fasting, and misuse of laxatives
and diuretics. Overeating at least twice
per week, with normal body weight,
lack of control of eating alternating
with starvation.

18.  or wasting syndrome is loss of weight, muscle atrophy, fatigue,
weakness, and significant loss of appetite in someone who is not
actively trying to lose weight. Even if the affected patient eats more
calories, still patent will lose weight. seen in patients with cancer,
metabolic acidosis, infectious diseases such as tuberculosis and
AIDS, COPD, multiple sclerosis, congestive heart failure, mercury
poisoning and addiction to amphetamine. Also includes sarcopenia.
if the patient has cachexia, the chance of death from the underlying
condition is increased dramatically.

19. Healthy diet concerning food quality,
quantity, nutrition such as vitamins,
calcium, iron, information about healthy
and unhealthy fats, water intake, sodium
intake limited to 1500 mg per day to avoid
water retention, hypertension, and
cardiovascular disease, according to
weight loss or gain.
Exercise at least 30 min per day
Decrease smoking
Sleep enough

21.  Surgery (removing part of the
stomach or by reducing its size)
 Prevent fat absorption by orlistat
(xenical)
 Use of compounds such as Beta-
phenylalanine which reduces food
intake.
 Re-esterification of FFA into
triacylglycerols by
thiazolidinedione drugs.

23. Miriam Ramez
Tbilisi State Medical University