We tailor assessment according to the individual’s risk factors. Common clinical observations and investigations include:
History:
Weight history (eg age of onset of obesity, minimum and maximum weight), previous weight loss attempts (including diets, medications, previous weight-loss surgery), triggers for weight gain/regain. Obesity-related comorbidities, family history, medication history. Current lifestyle: dietary behaviour and physical activity levels; work and home environment, psychosocial support.
Physical Examination:
Weight, body mass index, blood pressure. Signs of specific causes of obesity (eg hypothyroidism, Cushing’s syndrome).
Investigations:
Full blood count, urea and electrolytes, liver enzymes, coagulation screen, fasting lipids and glucose, HbA1c.
In known T2DM, C-peptide for pancreatic beta cell function.
Nutrition: ferritin, vitamin B12, folate, 25-OH vitamin D and Zinc.
For individuals with specific risks: ECG, echocardiogram or cardiology referral. Endoscopy for GORD, upper GI ultrasound for NASH or gallstones. Polysomnography for sleep apnoea.
Psychological:
Assess commitment, motivation, readiness to change, as well as understanding and expectations of surgery. Psychiatry review if known or suspected history of psychiatric illness or substance abuse.
We welcome referrals that include essential investigations as this can expedite the assessment process, however it is not necessary.