Sample Solution

A detailed history and physical examination is in order to elicit any cause of obesity and evaluation of consequences should be done depending on the age and degree of obesity.
1) History: It is a crucial part of evaluation of obesity and leading questions should be asked to elicit a cause as well as consequences of obesity.
A detailed history should be obtained regarding the onset (infancy/childhood), duration as well as the rapidity of weight gain. Infantile onset of obesity points towards a possibility of monogenic obesity.
A recent increase in appetite with rapid weight gain could suggest and intracranial mass especially if it is associated with headaches or visual disturbances.
Antenatal history and Birth weight are important in predicting the risk of complications. Children born small/large for gestation and those born to mothers with gestational diabetes mellitus have a higher risk of developing Type 2 Diabetes Mellitus.
History of developmental milestones may give a clue to the cause of obesity eg. Delayed motor milestones, feeding difficulty in infancy followed by a voracious appetite may be suggestive of Prader-Willi Syndrome.
Family history of obesity, diabetes mellitus, hypertension and dyslipidemia should be obtained.
History of intake of antipsychotics, anti-depressants or long-term corticosteroids should be obtained as they lead to weight gain.
Polyuria, polydipsia and unexplained weight loss may suggest onset of diabetes mellitus. Scanty and Delayed or missed periods in girls with or without hirsutism may suggest the presence of polycystic ovarian disease (PCOD).