Obesity in Primary Care: A Case of Endocrine-Associated Conditions

Published:November 26, 2022DOI:


      • Obesity is a complex disease that contributes to many serious health conditions.
      • Primary care nurse practitioners play an important role in treating obesity.
      • A case study discussing obesity and associated endocrine comorbidities is presented.
      • Obesity-related endocrinopathies include polycystic ovary syndrome, hypothyroidism, metabolic syndrome, diabetes mellitus, and nonalcoholic fatty liver disease.


      Obesity is a complex disease that contributes to increased risk for many serious health conditions. Primary care nurse practitioners play an integral role in the management and treatment of obesity, including endocrine conditions often associated with this chronic disease. This article provides information to increase the knowledge and confidence of nurse practitioners managing obesity and associated comorbidities in the primary care setting. An illustrative case study is presented, followed by a discussion of endocrine-related comorbidities including metabolic syndrome, hypothyroidism, polycystic ovary syndrome, and nonalcoholic fatty liver disease.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal for Nurse Practitioners
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bays H.
        • McCarthy W.
        • Burridge K.
        • et al.
        Obesity algorithm eBook.
        Obesity Medicine Association. 2021;
        • World Health Organization
        Obesity and overweight.
        • Centers for Disease Control and Prevention
        Adult obesity.
        • American Medical Association
        Public health: Recognition of obesity as a disease H-440.842.
        • Garvey W.T.
        • Mechanick J.L.
        • Brett
        • et al.
        American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity.
        Endocrine Pract. 2016; 22: 1-205
        • Centers for Disease Control and Prevention
        Defining adult overweight and obesity.
        • Tchang B.
        • Saunders K.
        • Igel L.
        Best practices in the management of overweight and obesity.
        Med Clin North Am. 2021; 105: 149-174
        • Heymsfield S.B.
        • Wadden T.A.
        Mechanisms, pathophysiology, and management of obesity.
        New Engl J Med. 2017; 376: 254-266
        • Gjermeni E.
        • Kirstein A.S.
        • Kolbig F.
        • et al.
        Obesity—an update on the basic pathophysiology and review of recent therapeutic advances.
        Biomolecules. 2021; 11: 1426
        • Sumithran P.
        • Prendergast L.A.
        • Delbridge E.
        • et al.
        Long-term persistence of hormonal adaptations to weight loss.
        New Engl J Med. 2011; 365: 1597-1604
        • Lorenzo C.
        • Williams K.
        • Hunt K.J.
        • Haffner S.M.
        The National Cholesterol Education Program—Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes.
        Diabetes Care. 2007; 30: 8-13
        • Sanyal D.
        • Raychaudhuri M.
        Hypothyroidism and obesity: an intriguing link.
        Ind J Endocrinol Metabol. 2016; 20: 554-557
        • Watson C.
        • Guilbeau J.
        Assessment and management: primary hypothyroidism in women.
        Women’s Healthc. 2021;
        • Legro R.S.
        • Arslanian S.A.
        • Ehrman D.A.
        • et al.
        Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline.
        J Clin Endocrinol. 2013; 98: 4565-4592
        • Legro R.S.
        • Dodson W.C.
        • Kunselman A.R.
        • et al.
        Benefit of delayed fertility therapy with preconception weight loss over immediate therapy in obese women with PCOS.
        J Clin Endocrinol. 2016; 101: 2658-2666
        • Perumpail B.J.
        • Khan M.A.
        • Yoo E.R.
        • Cholankeril G.
        • Kim D.
        • Ahmed A.
        Clinical epidemiology and disease burden of nonalcoholic fatty liver disease.
        World J Gastroenterol. 2017; 23: 8263-8276
        • Marino L.
        • Jornayvaz F.
        Endocrine causes of nonalcoholic fatty liver disease.
        World J Gastroenterol. 2015; 21: 11053-11076
        • Van der Valk E.S.
        • van den Akker E.L.T.
        • Savas M.
        • et al.
        A comprehensive diagnostic approach to detect underlying causes of obesity in adults.
        Obesity Rev. 2019; 20: 795-804
        • Huvenne H.
        • Dubern B.
        • Clement K.
        • Poitou C.
        Rare genetic forms of obesity: clinical approach and current treatments in 2016.
        Obesity Facts. 2016; 9: 158-173
        • Kushner R.
        Obesity 2021: Current clinical management of a chronic, serious disease.
        J Fam Pract. 2021; 70: S35-40
        • Ensign A.
        • Couch K.
        Improving effective weight management in a university health center.
        J Nurse Pract. 2021; 17: 1183-1188
        • Gadde K.M.
        • Martin C.K.
        • Berthoud H.R.
        • Heymsfield S.B.
        Obesity: pathophysiology and management.
        J Am Coll Cardiol. 2018; 71: 69-84
      1. Drugs and devices for weight management.
        Med Lett Drugs Ther. 2022; 64: 81-88
        • Centers for Disease Control and Prevention
        Get the facts: Sugar-sweetened beverages and consumption.
        • Chao A.M.
        • Quigley K.M.
        • Wadden T.A.
        Dietary intervention for obesity: clinical and mechanistic findings.
        J Clin Invest. 2021; 131: 1-10
        • Harris L.
        • Hamilton S.
        • Azevedo L.B.
        • et al.
        Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis.
        JBI Database System Rev Implement Rep. 2018; : 507-547
        • Bray G.A.
        • Heisel W.E.
        • Afsin A.
        • Jensen M.D.
        • Dietz W.H.
        • Long M.
        • Kushner R.F.
        • Daniels S.R.
        • Wadden T.A.
        • Tsai A.G.
        • Hu F.B.
        • Jakicic J.M.
        • Ryan D.H.
        • Wolfe B.M.
        • Inge T.H.
        The science of obesity management: An endocrine society scientific statement.
        Endocrine Reviews. 2018; 39: 79-132
        • Chung F.
        • Yang Y.
        • Brown R.
        • Liao P.
        Alternative scoring models of STOP-Bang Questionnaire improve specficity to detect undiagnosed obstructive sleep apnea.
        J Clin Sleep Med. 2014; 10
        • Westfall E.C.
        • Jeske R.
        • Bader A.R.
        Nonalcoholic fatty liver disease: common questions and answers on diagnosis and management.
        Am Fam Physician. 2020; 102: 603-612
      2. American Association of Nurse Practitioners. Obesity management fundamentals: essential clinical tools.

        • Ryan D.
        Next generation antiobesity medications: setmelanotide, semaglutide, tirzepatide and bimagrumab: What do they mean for clinical practice?.
        J Obes Metab Syndr. 2021; 30: 196-208


      Jill Roberts Hobbs, EdD, MSN, FNP-BC, ACNP-BC, CNE, is a clinical assistant professor, Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, and can be contacted at [email protected] Kimberly Ellison Wilson, DNP, FNP-C, is a clinical assistant professor, Capstone College of Nursing, University of Alabama, Tuscaloosa, AL. In compliance with standard ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.