Obesity
Obesity
Overweight: 25.0–29.9
Obesity Class I: 30.0–34.9
Obesity Class II: 35.0–39.9
Severe Obesity (Class III): ≥40.0
Super Obesity: ≥50.0
Super-Super Obesity: ≥60.0
All BMI categories
Lifestyle therapy: calorie reduction, physical activity, behavioral intervention
BMI ≥30 (or ≥27 with obesity-related comorbidity)
Anti-obesity medications:
Tirzepatide
Semaglutide
Liraglutide
Phentermine/Topiramate
Naltrexone/Bupropion
Orlistat
BMI ≥35–40 (depending on comorbidities)
Consider metabolic/bariatric surgery:
Sleeve Gastrectomy
Roux-en-Y Gastric Bypass
BMI is a screening tool, not a direct measure of body fat.
Health risk assessment should also consider body composition, muscle mass, age, sex, fat distribution, and obesity-related comorbidities.
Overweight: 25.0–29.9
Obesity Class I: 30.0–34.9
Obesity Class II: 35.0–39.9
Severe Obesity (Class III): ≥40.0
Super Obesity: ≥50.0
Super-Super Obesity: ≥60.0
All BMI categories
Lifestyle therapy: calorie reduction, physical activity, behavioral intervention
BMI ≥30 (or ≥27 with obesity-related comorbidity)
Anti-obesity medications:
Tirzepatide
Semaglutide
Liraglutide
Phentermine/Topiramate
Naltrexone/Bupropion
Orlistat
BMI ≥35–40 (depending on comorbidities)
Consider metabolic/bariatric surgery:
Sleeve Gastrectomy
Roux-en-Y Gastric Bypass
BMI is a screening tool, not a direct measure of body fat.
Health risk assessment should also consider body composition, muscle mass, age, sex, fat distribution, and obesity-related comorbidities.
A
Almonds: Provide Vitamin E, magnesium, and protein.
Avocado: Pack healthy monounsaturated fats and potassium.
Asparagus: Deliver chromium, fiber, and folate.
B
Broccoli: High in sulforaphane, fiber, and Vitamin C.
Blueberries: Loaded with antioxidants and low-glycemic carbohydrates.
Black Beans (Dry/Boiled): Packed with plant protein, fiber, and iron.
C
Chicken Breast: Packed with lean protein and selenium.
Citrus Fruits (Oranges/Limes): Lactose-free choice providing Vitamin C to lower cortisol.
Cherries: Rich in anthocyanins to reduce muscle soreness and inflammation.
D
Dark Leafy Greens: Provide iron, magnesium, and nitrates.
Dark Chocolate (85%+): Supplies magnesium, antioxidants, and healthy fats.
E
Eggs: Ultimate source of leucine, protein, and healthy fats.
Edamame (Fresh/Frozen): Offers plant-based protein, iron, and fiber.
F
Fish (Fresh/Frozen): Supplies ultra-lean protein and omega-3 fatty acids.
Salmon: Boosts fat loss via omega-3s.
Tuna: High-density lean protein source.
Cod: Low-calorie, pure muscle-building protein.
Flaxseeds: High in lignans, fiber, and alpha-linolenic acid.
American Society of Anesthesiologists (ASA) Physical Status Classification (Expanded):
ASA I: Normal healthy patient with no systemic disease.
Examples: Non-smoker, no alcohol or minimal use, BMI <25, normal blood pressure (<120/80), no medications, excellent functional capacity.
ASA II: Patient with mild systemic disease without significant functional limitation.
Examples: Controlled hypertension (e.g., BP <140/90 on medication), well-controlled type 2 diabetes (HbA1c ~6–7%), mild obesity (BMI 30–34.9), pregnancy, social alcohol use, current smoker without COPD, mild asthma, or mild OSA not requiring CPAP.
ASA III: Patient with severe systemic disease with substantive functional limitations.
Examples: Poorly controlled hypertension (BP ≥160/100), diabetes with HbA1c >8% or with complications (neuropathy), morbid obesity (BMI ≥40), chronic obstructive pulmonary disease (COPD), obstructive sleep apnea requiring CPAP/NIV, chronic kidney disease stage 3+, history of MI >3 months ago, chronic anticoagulation (e.g., atrial fibrillation on warfarin/DOAC), significant anemia, or active tobacco use with end-organ impact.
ASA IV: Patient with severe systemic disease that is a constant threat to life.
Examples: Recent MI (<3 months), unstable angina, decompensated heart failure (EF <30%), severe COPD with frequent exacerbations or oxygen dependence, advanced renal failure requiring dialysis, uncontrolled diabetes with end-organ damage, sepsis, or severe valvular disease.
ASA V: Moribund patient not expected to survive without the operation.
Examples: Ruptured abdominal aortic aneurysm, massive trauma, intracranial hemorrhage with mass effect, ischemic bowel with hemodynamic instability.
ASA VI: Brain-dead patient whose organs are being removed for donor purposes.
Modifier:
“E” (Emergency): Added to any classification when immediate intervention is required (e.g., ASA III-E, ASA IV-E), indicating increased perioperative risk due to urgency and limited optimization time.