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:
Ensure patient is not pregnant and (particularly if using Topiramate) is not at risk for pregnancy
Ensure patient does not have other contraindication to medications
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
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
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.