Obesity

HISTORY:

‍Inability to lose weightExcessive weight

Current weight: ‍ ‍kglbs

BMI: ‍

Attempts to lose weight so far: ‍none, ‍reduced fat, ‍reduced sugars, ‍reduced portions, ‍increased physical activity, ‍semaglutide, ‍bariatric surgery

‍fatigue

‍shortness of breath on exertion, ‍IIIIIIIV/IV

‍orthopnea

‍lower extermity edema

‍excessive hunger

‍increased appetite

‍anxiety

‍depression



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍

Musculoskeletal: joints ‍ ‍normal, ‍no limited ROM



ASSESSMENT:

‍Obesity ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍HbA1c, ‍fasting glucose, ‍lipid profil, ‍TSH, ‍cortisol

- Increase physical activity

- Dietary counseling

- ‍Weight loss medications

- Behavioral therapy

- Referral to dietitian

- Referral to weight loss clinic

- Referral to endocrinologist

- Referral to bariatric surgery

- Follow-up in ‍ months