WEST PALM BEACH, Fla. (AP) — Donald Trump’s doctor says the oldest man elected president is “fully fit” to serve as commander in chief as the White House released results Sunday of Trump’s recent physical exam. The 78-year-old Trump is 20 pounds lighter since his checkup as president in 2020 showed him bordering on obesity.

His physician, Navy Capt. Sean Barbabella, cited an “active lifestyle” that ”continues to contribute significantly” to the Republican president’s well-being. Trump turns 79 on June 14.

In a three-page summary of the comprehensive exam from Friday, the doctor said Trump is “fully fit to execute the duties of Commander-in-Chief and Head of State.” Trump weighed 224 at the checkup, down from 244 at that physical more than four years ago.

His BMI, or body mass index, which is a measure of one’s weight relative to height, is down to 28.0, which drops Trump to the category of overweight. The president’s BMI came in at 30.5 in 2020, which pushed him just over the edge into the category of obesity.

The summary noted that Trump previously had cataract surgery on both eyes, but gave no date or dates. A common procedure among aging people, the surgery typically involves removing a cloudy eye lens and replacing it with an artificial lens to help clear up vision.

In July 2024, according to the report, then-candidate Trump had a colonoscopy that found a benign polyp and the condition called diverticulosis. It’s a common condition in which the walls of the intestine weaken with age. It can lead to inflammation, though most people with it never experience any problems.

Trump again passed a Montreal Cognitive Assessment test, a short screening test to assess different brain functions, Barbabella wrote. The test includes remembering a list of spoken words and listening to a list of random numbers and repeating them backward, among other questions.

Known as MoCA, it’s the same test Trump took in 2018 and later recounted in an interview in which he described reciting a list of words in order: “Person. Woman. Man. Camera. TV.”

The president also was screened Friday for depression and anxiety, and had normal scores on questionnaires for those conditions, according to the report.

Asked about the exam on Sunday and how he stays healthy, Trump said, “Because I enjoy what I’m doing and I like the results.

“I think we’re making America great again and it makes me feel good. It probably keeps me happy,” he told reporters accompanying him on a flight back to Washington from Florida.

Trump may be the oldest person elected to the nation’s highest office, but he is four years younger than Democrat Joe Biden, who was 82 when his presidential term ended in January.

Despite raising persistent questions about Biden’s physical and mental capacity and repeatedly asserting that Biden did not know what he was doing, Trump has routinely kept basic details about his health shrouded in secrecy, in contrast to the traditional transparency on medical issues that presidents of both political parties have shown.

Presidents have the right to keep their medical information private. Releasing the results of modern annual physicals, though, often helps reassure the public about their president’s health.

In his memo, Barbabella wrote that Trump remains in “excellent health” with “robust cardiac, pulmonary, neurological and general physical function.”

The doctor said Trump’s days are filled with meetings, public appearances, media availabilities and “frequent victories in golf events.” Trump is an avid golfer who said he recently won tournaments played at clubs he owns in Florida

Trump’s cholesterol levels have improved over time, helped by the medications rosuvastatin and ezetimibe.

At his physical in January 2018, his total cholesterol was 223. In early 2019, the reading came in at 196 and it stood at 167 in 2020. Today it is 140. Ideally, total cholesterol should be less than 200.

His blood pressure was 128 over 74. That is considered elevated, and people in that situation are likely to develop high blood pressure unless steps are taken to control the condition.

Trump has a resting heart rate of 62 beats per minute, in line with previous tests. A normal resting heart rate for adults ranges from 60 beats to 100 beats per minute, and generally, a lower rate implies better cardiovascular fitness.

Trump also takes aspirin, which can reduce the risk of heart attack and stroke.

The exam found minor sun damage to Trump’s skin and a few benign lesions, but no concerning lesions or growth. It also confirmed scarring on Trump’s right ear from a gunshot wound during an assassination attempt at a Butler, Pennsylvania, campaign rally in July 2024.

Barbabella performed and supervised the medical exam at Walter Reed National Military Medical Center in Bethesda, Maryland, and said it included diagnostic and laboratory testing in addition to consultations with 14 specialists.

Barbabella is a decorated Navy physician who specializes in emergency and tactical medicine and served several tours of duty in Iraq and Afghanistan. He has a Purple Heart and a Legion of Merit award, two of the military’s highest honors.

Barbabella is also the third consecutive osteopathic doctor to serve as physician to the president, following Biden’s doctor and one of the doctors who cared for Trump in his first term. Barbabella ran a naval health clinic in Havelock, North Carolina, before Trump tapped him for the job.

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Associated Press writer Jonathan Poet in Philadelphia contributed to this report.