It is important to determine the presence of any cardiac risk factors such as hypertension, hyperlipidaemia and cigarette smoking and to provide appropriate advice and therapy. The physical symptoms of obesity include reduced mobility, joint pain, chest pain, breathing difficulties and sleeping difficulties, and these should also be assessed. Conditions such as osteoarthritis and gastrointestinal disorders such as gastric reflux can also be exacerbated by excess weight. As well as measures of glycaemic control, measurements of biochemical indices such as lipid levels and thyroid levels are advisable.
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