Undiagnosed obesity: implications for undiagnosed hypertension, diabetes, and hypercholesterolemia.

BACKGROUND AND OBJECTIVES Since obesity is a risk factor for hypertension, diabetes, and hypercholesterolemia, health care providers should screen obese individuals for these common diseases. It is possible that obese adults are not receiving appropriate screening for these diseases. This study's objective was to describe the prevalence of undiagnosed obesity, diabetes, hypertension, and hypercholesterolemia, in a nationally representative sample of obese US adults, by patients' recollection of whether they had received such a diagnosis. METHODS The prevalence of undiagnosed disease was obtained by identifying respondents in the 1999-2000 National Health and Nutrition Examination Survey (NHANES) who had findings consistent with a condition but who did not report being told they had that condition by a health care provider. RESULTS The prevalence of undiagnosed obesity, diabetes, hypertension, and hypercholesterolemia in currently obese US adults is 22.9%, 11.3%, 16.1%, and 37.7%, respectively. Significant predictors of undiagnosed obesity include black race and younger age. In addition, obese adults with excellent self-reported general health condition and lower body mass index are less likely to have diagnosed obesity. CONCLUSIONS Health care providers are missing valuable opportunities to address obesity and diagnose diabetes, hypercholesterolemia, and hypertension in obese adults. An emphasis on screening obese individuals for these diseases is needed to improve health promotion.