Patient Care Plans

Patient Care Plan

Assessing for Causes of Obesity

  • Remove offending medications
  • Consider genetic testing if onset before 5 years of age
  • Screen for mood disorder, hormone disorders based on symptoms

Interventions:

  • Nutrition
  • Physical activity
  • Behavioral:
    - Eating habits
    - Sleep
  • Medical therapy options
  • Surgical therapy options

Screening for Comorbidities

  • Mood disorder
  • Eating disorder
  • OSA
  • NAFLD
  • Dyslipidemia
  • Diabetes
  • Other

Relative comparison of the efficacy of various strategies to promote weight loss

*Insurance coverage for these procedures is dependent on the patient's plan and should be consulted for insurance-specific coverage.

Medication

Recommended for patients with BMI ≥ 30 or ≥ 27with obesity-related comorbidity

FDA Approved medications for weight loss: 

  • Liraglutide (Saxenda)
  • Naltrexone-Bupropion (Contrave)
  • Orlistat
  • Phentermine Topiramate (Qsymia)
  • Semaglutide (Wegovy)

How to choose your med:

General Advice Regarding Medications:

  1. Ensure patient is not pregnant and (particularly if using Topiramate) is not at risk for pregnancy
  2. Ensure patient does not have other contraindication to medications
  3. Ensure patient has informed consent regarding
    a.  Off label use of the medication (if applicable)
    b.  Need for long-term use/acknowledgement that stopping med is likely to be associated with weight regain
  4. If patient has not lost at least 5% body weight after 3 months on max dose of the medication, recommend stopping the medication and considering an alternative therapy
  5. Recommend continuing the medication as long as it is effective and not contraindicated.

Find out if your patient’s insurance company covers Anti-Obesity Medications (AOMs)

We recommend getting this information before completing a prior authorization to use time efficiently, as many insurance companies have clear exclusion policies for AOMs. 

Surgical and Endoscopic Procedures

For patients who meet criteria, bariatric surgery is a long-lasting and efficacious tool for promoting weight loss.

Types of Endoscopic Therapy

Types of Surgery (most commonly performed today)

Criteria for bariatric surgery

  • Body Mass index>35
  • Body Mass index>30 w/an obesity-related comorbidity including
    - High blood pressure
    - Type 2 Diabetes
    - Obstructive Sleep Apnea 

Additional bariatric surgery information