Mesomorphic body states, as seen in bodybuilders and people in related occupations (e.g., professional wrestling), may be associated with elevated BMIs, but as a result of increased muscle mass rather than excess adiposity. In addition, anasarca may be mistaken for obesity if not carefully evaluated clinically. Other conditions to consider while examining for obesity include the following:

• Depression;
• Type 2 diabetes mellitus;
• Fatty liver;
• Gastroesophageal reflux disease (GERD);
• Hirsutism;
• Polygenic hypercholesterolemia;
• Hypothyroidism;
• Insulinoma;
• Kallmann syndrome and idiopathic hypogonadotropic; hypogonadism;
• Generalized lipodystrophy;
• Polycystic ovarian disease (Stein-Leventhal syndrome);
• Cushing syndrome;
• Adiposa dolorosa (Dercum disease);
• Partial lipodystrophies associated with localized lipohypertrophy.