President Donald Trump weighed 243 pounds at his physical on Feb. 8, meaning he is now considered obese.

He has gained four pounds since his previous official checkup 13 months ago, giving him a body mass index of 30.4. A person with a BMI of 30 or above is defined as obese.

Obesity, which affects more than 90 million U.S. adults, is associated with a higher risk of heart disease, stroke, and type 2 diabetes, according to the U.S. Centers for Disease Control and Prevention.

That does not mean Trump is suddenly at much higher risk for those conditions. They also are associated with being overweight, which he was at his previous checkup in January 2018. The president’s BMI then was 29.9, at the upper end of being considered overweight for a man of his height, listed at 6 feet 3 inches.

The president was examined by physician Sean P. Conley this month at Walter Reed National Military Medical Center, the White House said Thursday. Conley, a Navy commander, said he was assisted by a panel of 11 board-certified specialists.

“After taking into account all the laboratory results, examinations and specialist recommendations, it is my determination that the president remains in very good health overall,” Conley said, in a memo released by the White House.

The president’s blood pressure was measured at 118 over 80. The lower of those two numbers, called diastolic blood pressure, is considered borderline high, according to the most recent guidelines from the American Heart Association. Conley described the president’s liver, kidney, and thyroid function as normal.

During his physical, Trump received the Shingrix vaccine, which protects against the debilitating disease of shingles. He also got the Pneumovax 23 vaccine, which reduces a person’s risk of pneumococcal infection and is recommended by the CDC for all adults age 65 or older.