The patient's age is important in determining risk from obesity and generally there is greater risk from obesity in those under 40 years of age. Taking a weight history can ascertain the onset and duration of obesity as well as the pattern of weight gain and weight loss throughout the individual's life. Longitudinal studies have shown that weight gain confers a greater risk of cardiovascular disease than an unchanging level of obesity (40). In addition, the longer the duration of obesity the more difficult treatment may be. Gender is another variable that impacts on the development of obesity, with women generally having a higher prevalence of obesity compared to men, especially in middle age (41). Reproductive function can be affected in younger women, with menstrual disorders including irregular bleeding and amenorrhea being more common among obese females.
Various medical/genetic causes of obesity must also be considered. Endocrine conditions associated with weight gain include hypothyroidism, Cushing's syndrome, hypogonadism in the male, polycystic ovary syndrome (PCOS) in the female and growth hormone deficiency (42). Rare genetic causes of obesity include Prader-Willi syndrome, Bardet-Biedl syndrome and Cohen's syndrome. Diabetes can be an obvious consequence of the severe obesity associated with such syndromes.
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A time for giving and receiving, getting closer with the ones we love and marking the end of another year and all the eating also. We eat because the food is yummy and plentiful but we don't usually count calories at this time of year. This book will help you do just this.