Obesity

Data gathering

  • Red flags – SOB, chest pain, mood
  • Others
  • Ex – BMI, BP, CV

 

Clinical management

  • Investigations
    • Bloods – fasting cholesterol/glucose, U+Es, LFTs, TFTs, LH/FSH
  • Explanation
    • obesity BMI >30, energy intake exceeds use, inc risk of DM, BP, heart disease, cancers
  • Treatment
    • Lifestyle
      • Diet – fruit/veg/fish/lean meat/less sugar/reduction in portions and calories
      • Exercise – 30mins OD for 5 days, practical things like stairs
      • Alcohol – reduce
      • Smoking cessation
    • Medications – orlistat – BMI>30, must lose 5% of weight in first 3 months to continue, SE: fatty stools, flatulence (or >28 with co-morbidites)
    • Surgery – BMI >35 + other co-morbidities when above treatments failed or BMI > 40
    • Refer – Dietician, exercise program
  • Follow Up – see again in 2/52

NB: realistic targets e.g. 1kg/week