American Board of Internal Medicine (ABIM) Certification Practice Exam

For patients with a BMI of 27 or higher, what additional factor qualifies them for pharmacologic therapy?

1. Being physically active

2. Lack of weight loss

3. Presence of obesity-associated comorbidities

4. Being a smoker

The correct answer is: Presence of obesity-associated comorbidities

Patients with a BMI of 27 or higher qualify for pharmacologic therapy if they have obesity-associated comorbidities. This means that not only is their weight itself a factor, but the presence of additional health conditions related to obesity plays a crucial role in determining the need for medication. These comorbidities can include conditions like type 2 diabetes, hypertension, dyslipidemia, sleep apnea, or osteoarthritis. When these complications are present, the benefits of pharmacologic therapy may significantly outweigh any potential risks, thus justifying the use of medications to aid in weight management. The other factors, such as being physically active or being a smoker, do not necessarily indicate a need for pharmacologic intervention. Being physically active is generally beneficial for overall health and weight management, but it does not alone warrant medication. Similarly, while smoking is a risk factor for numerous health issues, it does not directly correlate with the requirements for obesity treatment pharmacology. Lack of weight loss following lifestyle modifications might prompt consideration for medication, but the decisive factor here remains the presence of obesity-related comorbidities, as they provide a clear clinical rationale for initiating drug therapy.