Outcome evaluation

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Successful management of overweight and obesity is determined by the ability the treatment plan has to: (a) prevent weight gain, (b) reduce and maintain a lower body weight, and (c) decrease the risk of obesity-related comorbidities. Since weight is necessary to calculate the BMI, it, as well as waist circumference, should be determined. Obesity management may encompass more than weight loss or maintenance in the presence of other conditions; other pertinent parameters should be assessed at baseline. The presence of hypertension, type 2 diabetes, hyperlipidemia, CAD, sleep apnea, hypothyroidism, osteoarthritis, gallbladder disease, gout, or cancer should be determined. Blood pressure and heart rate should be measured prior to implementation of any therapy. Certain laboratory parameters also should be assessed. A basic metabolic panel, liver function tests, complete blood count, fasting lipid profile, full thyroid function tests, and other laboratory studies as deemed necessary should be obtained. An electrocardiogram should be performed if recent results are unknown.6

The patient should be assessed in 2 to 4 weeks following the implementation of therapy to determine effectiveness of and intolerance to treatment. Monthly visits are encouraged during the first 3 months. More frequent follow up may be necessary in the presence of other medical conditions. Less frequent follow up occurs after 6 months of effective weight-loss therapy.6

At each follow-up visit, compliance with a healthy lifestyle should be determined, as well as measurement of physical parameters, including weight, blood pressure, and heart rate. Waist circumference should be measured intermittently. A complete assess ment also would include identification of adverse drug reactions or drug interactions if weight-loss medications have been initiated.6

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