Evaluation of the Obese Patient-Reply

George A. Bray, MD
JAMA. 1976;236(15):1692. doi:10.1001/jama.1976.03270160015010.
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The series in the The Journal entitled TOWARD OPTIMAL LABORATORY USE was intended to focus on the laboratory as an instrument in the diagnosis of disease and as a tool for following treatment. The algorithm that we constructed had this goal in mind. From the frequency with which hypertension, hyperlipidemia, hyperglycemia, and abnormal thyroid function tests were uncovered when using this algorithm, it should be apparent that these are conditions for which obesity may be a valuable marker. Although the diabetics were known before our screening, there were no clinical criteria suggesting thyroid disease in the two patients with abnormal laboratory values (2/57 = 4%). Many of the measurements suggested in this algorithm are also appropriate for other patients, as Dr Gillette notes, but the frequency of abnormalities might well be different.

Dr Gillette has pointed out the desirability of obtaining additional information about obese patients, and I completely


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