A Patient Journey for Weight

It can be difficult to know whether your weight level is a healthy one. The medical profession uses guidelines such as height/ weight charts, abdominal girth (measurement around a specific point of the abdomen), and, most commonly, body mass index (BMI) to determine whether an individual is underweight, of normal weight, or overweight. BMI is calculated by dividing a person's weight in kilograms by the square of their height in metres. A BMI below 18.5 is considered underweight and above 25 overweight. A person is considered obese if their BMI is above 30.

Being severely underweight or obese increases the risk of serious health problems, and extreme weight change may come about for medical reasons – such as thyroid disorders (failures of the thyroid gland – a gland in the neck that produces hormones that play a role in metabolism regulation – to function normally) or Cushing's syndrome (a disorder resulting from the overproduction of cortisol, a hormone, leading to weight gain among other symptoms) – as well as for genetic, hormonal, or behavioural reasons. So, if you think you may be severely under- or over-weight, or if you go through extreme weight change, you should see your GP.

Your doctor will ask about your previous weight history; your lifestyle including calorie intake, eating pattern, and the amount of physical activity you undertake; whether you have any existing medical conditions or are taking any medications; about psychological factors. He or she may also undertake a general physical examination, including the sorts of tests mentioned above, taking your weight, height, abdominal girth, blood pressure and heart rate. Examinations of the heart, lungs, and abdomen are also quite normal – as are blood tests and electrocardiograms (or ECG; a test using electrodes placed on the body that establishes whether there are any problems with the electric activity of the heart).

It may be discovered that there are underlying problems associated with your weight problem. People who are overweight may, for example, suffer from diabetes, sleep apnoea (periods during sleeping in which air is prevented from entering the lungs by an obstruction), or polycystic ovary syndrome (a condition affecting many women in which their ovaries develop cysts and fail to release eggs regularly). Adults or teenagers who are underweight, meanwhile, may suffer from anaemia (a lack of iron in the body), osteoporosis (a condition in which the bones become brittle which can occur for a number of reasons) or fertility problems. In these cases, your GP may refer you to a specialist for further evaluation and treatment. Similarly, in the case of individuals with suspected eating disorders such as anorexia nervosa or bulimia, you may be referred to a specialist clinic involving dietitians, specialist nurses, or psychiatrists.

In many cases, your doctor will advise lifestyle changes: instituting an exercise regime, for example, or alterations to your diet, including cutting out certain foods. More drastic treatments may be required in some cases: medication (you should always consult your doctor before taking any slimming pills or similar medications), psychological therapies or even surgery.

It is important for a patient to have some understanding about their condition – talkhealth recommends Weight Concern and Hoop for advice, information, and support. For thyroid issues, talkhealth recommends the British Thyroid Foundation.

You can also talk to other people concerned about weight issues in our talkweight forum, and browse our weight blog for the latest news, advice, and opinions.