- See Obesity for diagnostic criteria
- Temporary Exclusions
- Pregnancy
- Lactation (allowed if milk established)
- Unstable mental or medical illness
- Possible Exclusions
- Cholelithiasis
- Osteoporosis
- Permanent Exclusions
- Anorexia Nervosa
- Terminal illness
- History of lifetime weight changes
- Medical conditions and medications predisposing to weight gain
- See Medications Associated with Weight Gain
- Prior weight management strategies and their effectiveness?
- Prior Obesity Medication use
-
Family History of Obesity and metabolic conditions
- Social history
- Substance use (Tobacco, Alcohol, Illicit Drug use)
- Behavioral health (e.g. Major Depression, Anxiety Disorder, emotional stress, Trauma, PTSD)
-
Physical Activity (work, home, Exercise)
- Nutrition history
- Meals (timing, portions, content, preparation)
- Habits or disordered eating that may benefit from modification (e.g. Binge Eating)
-
Vital Signs
- Oropharynx
- Mallampati Score (Grades 3-4 associated with Sleep Apnea)
-
General Exam
- Cardiopulmonary exam
- Skin exam
- Determine Obesity Measurements
- See Obesity Measurement
- Body Mass Index (BMI)
- Waist Circumference
- Neck circumference (best predictor of Sleep Apnea)
-
Fasting Lipid profile
- Chemistry panel (including Fasting Serum Glucose)
-
Thyroid Stimulating Hormone (TSH)
- Rarely the cause for weight gain
- See Obesity Management
- Evaluate Comorbid Obesity Risk
- Is Patient Ready and Able to lose weight?
- Yes: Weight Reduction Protocol
- No: Prevention of Weight Gain Protocol
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