Certified Obesity Medical Physician (COMP)

Domain 02: Diagnosis and Evaluation

History
Physical Examination
Diagnostic Testing

Medication history (e.g., drug induced weight gain, prior weight loss, medication use, dietary supplements, drug induced co-morbidities)
Demographic/socioeconomic/cultural/lifestyle/occupational information that may influence treatment approaches
Family history of obesity and co-morbidities (e.g., early cardiovascular disease, hypertension, maternal gestational diabetes, T2 DM, hypertension, etc.)
Previous weight loss attempts, successes, and failures (e.g., consultations, programs)
Co-morbidity history (including prior surgeries)
Sleep history
Physical activity, including:

Current physical function, mobility status and barriers

Current and past physical activity and exercise level

Time spent in sedentary behavior (pediatric and adult)

Methods/strategies for obtaining physical activity and exercise history

Family activity level/leisure activity

Behavior/psychosocial, including:

History of mood, anxiety, psychosis, eating, and personality disorders

Weight-related quality of life

Alcohol, tobacco, and substance abuse

Patient self-perceptions related to weight control (locus of control)

Eating triggers (e.g., emotional/situational)

Readiness to change (including parental readiness in pediatrics)

Coping and stress

History of physical, emotional, sexual abuse

Food access

Patient’s/family’s food security

Parenting style

Weight gain/loss history (e.g., relationship to life events, smoking, pregnancy)
Nutrition/diet, including:

Methods/strategies for obtaining diet history (e.g., FFQ, 24 hour recall, random day recall) and pattern, including when proxy reports are necessary (e.g. parents)

Diet history interpretation

Food allergies and intolerances

Assessment of caloric and nutritional needs

Patients’/parents’ nutrition knowledge (e.g., reading food labels)

Food choices and eating patterns (meals/snacks per day/meals away from home)

Eating out (frequency, where)

Infant/early childhood feeding

Physical Examination

BMI classification/BMI percentile and cut points (e.g., ethnic, sex and age specific)
Waist circumference (e.g., ethnic and age specific)
Neck circumference
Obesity related physical findings
Vital signs
Physical findings related to underlying syndromes (genetic, metabolic) causing obesity (e.g., Cushingoid habitus, short stature)
Lipomatosis
Signs of nutritional deficiency
Tanner stage

Diagnostic Testing

Indications and interpretation of resting metabolic rate
Indications and interpretation of body composition analysis
Screening questionnaires (e.g., sleep apnea, depression, gastroesophageal reflux disease)
Indications and interpretation of diagnostic tests for obesity co-morbidities (e.g., sleep study, EKG, fasting glucose, liver function test, lipid profile, insulin, oral glucose tolerance test)
Indications and interpretation of diagnostic tests for secondary obesity (e.g., cortisol, TFTs, chromosome analysis (especially in children), GH)
Medical clearance for exercise and surgery
Research tools (e.g., calorimetry, doubly labeled water, stable isotopes, accelerometers, VO2 testing)

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