All new patients undergo an evaluation with me that involves a detailed history, laboratory blood testing and a brief, 'clothes-on' physical examination. The purpose of this process is several-fold: to make a basic and general determination of your health, to check for illnesses that may be caused by weight or, in turn, illnesses, conditions or medications that may themselves actually cause weight gain, and finally to determine your suitability for various weight loss strategies including diet, exercise and medication. Your health is monitored throughout your time as a patient of mine.
Metabolic syndrome is strongly associated with obesity and especially with visceral fat (fat around the internal organs). Metabolic syndrome leads to type-II diabetes, elevated levels of bad cholesterol and triglycerides, increased blood pressure, generalized inflammation throughout the body, increased risk for heart and cardiovascular disease and perhaps most insidiously, it seems to cause all the tissues in the body, but especially fat itself, to become resistant to the effects of important weight-reducing hormones like insulin and leptin. In other words, metabolic syndrome is caused BY obesity but it, in turn, causes more obesity which worsens the metabolic syndrome...and so on. Fortunately, metabolic syndrome can be managed through weight control. Rest assured that I carefully screen all patients for metabolic syndrome.
PCOS shares many of the features of metabolic syndrome and occurs in about 10% of woman. It is another condition for which I carefully screen female patients (no invasive testing is required---it's largely based upon history).
Although hypothyroidism is quite common, it is only weakly associated with obesity, but it is one of the conditions I am careful to evaluate patients for.
Screening For Cardiovascular Risk