Obesity so how we kind of screen for that or measure for that is it just about putting a patient on the scale or is there a little bit more involved for now we use a body mass index which is the BMI and that uses the height and weight to give an idea of how overweight an individual is I think that there are more sophisticated ways there is fat analysis lean body mass composition testing that can be done I think as a society we’re seeing more obesity and so we will need to evolve our technology to assess for obesity and body mass index in a more efficient way and in fact there’s an entire specialty of medicine called obesity medicine now and targeted at prevention and treating and managing obesity okay because it is becoming a problem we do hear more and more about obesity and how it’s affecting people all throughout the country and that being said you know obviously you have patients of course who might be struggling with their weight so just wondering how you really try to help those patients of course everyone is different but in general helping those patients who might be dealing with weight issues obesity and especially if they are at risk for diabetes mm-hmm I think it’s very important to first of all have a comfortable relationship with your doctor because these are uncomfortable conversations to have you have to be ready and willing to accept what the results is that there is a risk of diabetes or cholesterol or heart disease or blood pressure and be willing to want to make a change I think that’s very important and if you are accepting help having support resources I think once before we talked about being forgiving that there may be some days that you slide backwards a little bit but at least as a physician I feel that the accountability portion is really important and and coming in for those follow-ups and not you know cancelling your appointment because you’re afraid that you didn’t achieve what you need to being accountable allowing us to support you to remind you to be on the right track that’s all really important