Josephin Doe

Lary Doe

Alice

Alia

Suzen

Josephin Doe

Obesity Risk Questionnaire

Age

Sex

Sex influences fat distribution and risk profiles.

Weight (kg)

Used to calculate BMI.

Height (cm)

Used to calculate BMI and WHtR.

Waist Circumference (cm)

Measures central obesity (WHtR > 0.5 indicates higher risk).

Body Composition (Optional)

Body Fat Percentage (%)

High body fat (>30% men, >40% women) increases metabolic risk (Neeland et al., 2018).

Android-to-Gynoid Fat Ratio

Ratio >1.0 indicates higher cardiometabolic risk (Kang et al., 2011).

Android Fat Mass (kg)

Visceral fat increases diabetes and MASLD risk (Després et al., 2008).

Android Fat Percentage (%)

Percentage of total weight; >10% increases risk.

Gynoid Fat Mass (kg)

Subcutaneous fat may be protective (Okura et al., 2007).

Gynoid Fat Percentage (%)

Percentage of total weight; >15% may reduce risk.

Comorbidities

Select any diagnosed conditions.

Type 2 Diabetes

Dyslipidemia

Polycystic Ovary Syndrome (PCOS)

Obstructive Sleep Apnea

Hypertension

Osteoarthritis

These conditions increase complication risks (Source: WHO, CDC).

Lab Results (Optional)

HbA1c (%)

Measures blood sugar control (normal: <5.7%).

LDL Cholesterol (mg/dL)

High LDL increases cardiovascular risk.

AST (U/L)

Used for FIB-4 score (liver fibrosis risk).

ALT (U/L)

Used for FIB-4 score.

Platelet Count (10⁹/L)

Used for FIB-4 score.

Interventions (Optional)

Intervention

Medications and surgery reduce risks via weight loss and metabolic effects (STEP, SURMOUNT, ASMBS).

Lifestyle Factors

Physical Activity (min/week)

WHO recommends 150-300 min/week.

Smoking Status

Smoking exacerbates cardiovascular risk.

10-Year Risk Assessment Results

10-Year Risk (%)

The 10-Year Risk reflects the risk after applying the selected intervention (if any). The table’s Current Risk column shows the baseline risk before intervention.

Weight Loss and Intervention Impact on Outcomes

Outcome	Current Risk (%)	5% Loss	10% Loss	15% Loss	20% Loss	Semaglutide (Oral)	Semaglutide (Injectable)	Tirzepatide	Metabolic Surgery

*Estimate based on non-inferiority meta-analysis and weight loss impact; no dedicated cardiovascular outcomes trial (CVOT) available for tirzepatide.

Weight Loss Impact Chart (by Outcome)

Methodology

10-year risks are calculated using baseline incidence rates adjusted by hazard ratios (HRs) for BMI, WHtR, body composition, comorbidities, lab results, and lifestyle factors. Outcomes are defined as follows:

Diabetes: 10-year risk of developing Type 2 Diabetes Mellitus (T2DM), defined as a new diagnosis (fasting plasma glucose ≥126 mg/dL, HbA1c ≥6.5%, or clinical diagnosis) in individuals without baseline diabetes.
Cardiovascular Disease (CVD): 10-year risk of a major cardiovascular event, including coronary heart disease (myocardial infarction, coronary revascularization, or CHD death), cerebrovascular events (ischemic stroke or transient ischemic attack), or heart failure requiring hospitalization.
Malignancy: 10-year risk of developing obesity-related cancers (e.g., breast, colorectal, endometrial, esophageal, kidney, pancreatic, liver), as defined by the International Agency for Research on Cancer.
Osteoarthritis: 10-year risk of developing symptomatic osteoarthritis in weight-bearing joints (e.g., knees, hips), defined as new onset of joint pain, stiffness, or swelling with radiographic evidence (Kellgren-Lawrence grade ≥2) or clinical diagnosis.
MASLD: 10-year risk of developing Metabolic Dysfunction-Associated Steatotic Liver Disease, defined as hepatic steatosis with metabolic dysfunction (e.g., obesity, insulin resistance), without significant alcohol consumption.
All-Cause Mortality: 10-year risk of death from any cause, including cardiovascular, cancer, liver-related, and other obesity-related causes.

Incidence rates and HRs are derived from Framingham Heart Study, Diabetes Prevention Program, DIRECT trial, WHO cancer risk models, and osteoarthritis/MASLD literature. FIB-4 requires AST, ALT, and platelet inputs; otherwise, marked as insufficient. Weight loss reduces risk linearly (e.g., 1% weight loss reduces diabetes risk by ~5%, capped at 70% per DIRECT trial; mortality by ~2%, capped at 50%). Interventions apply OR reductions with 95% CI based on STEP, SURMOUNT, and SOS data. Mortality risk is based on WHO Global Burden of Disease, adjusted by HRs from Flegal et al. (2013) and intervention studies (SELECT, TriNetX, SOS). Android/gynoid fat mass is prioritized over percentage if provided.

References

Lean et al. (2018). Primary care-led weight management for remission of type 2 diabetes (DIRECT). Lancet, 391:541-551.
Neeland et al. (2018). Cardiovascular and metabolic heterogeneity of obesity. Circulation, 137:1391-1406.
Kang et al. (2011). Android fat distribution and diabetes risk. Diabetes Care, 34:197-203.
Després et al. (2008). Abdominal obesity and metabolic syndrome. Arterioscler Thromb Vasc Biol, 28:1039-1049.
Okura et al. (2007). Protective effect of gynoid fat. Obesity, 15:1477-1485.
Angulo et al. (2007). FIB-4 score for liver fibrosis. Hepatology, 45:846-854.
Look AHEAD Research Group (2013). Cardiovascular effects of intensive lifestyle intervention. NEJM, 369:145-154.
Wilding et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. NEJM, 384:989-1002. (STEP 1)
Davies et al. (2021). Semaglutide 2.4 mg vs. 14 mg oral for weight loss. Lancet, 397:971-984. (STEP 8)
Jastreboff et al. (2022). Tirzepatide for obesity. NEJM, 387:205-216. (SURMOUNT-1)
Lincoff et al. (2023). Semaglutide and cardiovascular outcomes in obesity. NEJM, 389:2221-2232. (SELECT)
Aminian et al. (2019). Bariatric surgery and cardiovascular outcomes. JAMA, 322:1271-1282.
Garvey et al. (2024). Tirzepatide for diabetes prevention. NEJM, 391:2023-2035. (SURMOUNT-1 3-year)
Sjöström et al. (2014). Bariatric surgery and long-term cardiovascular events. JAMA, 311:2297-2304. (SOS)
Lauby-Secretan et al. (2016). Body fatness and cancer. NEJM, 375:794-798.
Messier et al. (2013). Weight loss and osteoarthritis. JAMA, 310:1263-1273.
Flegal et al. (2013). Association of all-cause mortality with overweight and obesity. JAMA, 309:71-82.
Rao Kondapally Seshasai et al. (2011). Diabetes and vascular mortality. NEJM, 364:829-841.
Younossi et al. (2016). Global epidemiology of NAFLD. Hepatology, 64:73-84.
Vilar-Gomez et al. (2015). Weight loss and NAFLD resolution. Gastroenterology, 149:367-378.
Lassailly et al. (2015). Bariatric surgery reduces NAFLD. Gastroenterology, 149:379-388.
Ma et al. (2017). Effects of weight loss interventions on mortality. BMJ, 359:j4849.
TriNetX Study (2024). Tirzepatide vs. semaglutide in obesity. eClinicalMedicine, 2024 Aug.
D’Agostino et al. (2008). General cardiovascular risk profile for use in primary care. Circulation, 117:743-753.
Rinella et al. (2023). A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology, 78:1966-1986.