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Initial Physician Assessment

Your initial appointment will consist of a full history & physical with all of the standard components, including:

  • Chief Complaint
  • History of Present Illness
  • Past Medical, Family, and Social Histories (including medication reconciliation)
  • Detailed Review of Systems
  • Comprehensive Physical Exam
  • Review of Any Available Laboratory Testing
  • 12-Lead Electrocardiogram if Indicated

In the appointment, we will also assess the following:

  • Current overall health status
  • Obesity history and status including but not limited to:
    • Development and progression of the disease
    • Contributing factors
    • Genetic and environmental influences
    • Nutrition history
    • Physical activity history
    • Prior treatment attempts (both self treatment as well as medical)
    • Reasons for prior successes and failures
    • Contributing medications
  • Assessment for eating disorders or other psychological contributors
  • Assessment of obesity and metabolic syndrome related medical comorbidities
  • Assessment of patient readiness for change
  • Acquisition of additional health related data including, but not limited to, the following labs:
    • Comprehensive metabolic panel to assess electrolytes, renal function, hepatic function,
    • Complete blood count
    • Urinalysis and urine microalbumin
    • Lipids, potentially including advanced lipoprotein assessment
    • Assessment of insulin and glucose metabolism using fasting insulin and glucose and
    • Selective use of oral glucose tolerance testing
    • Assessment of chronic inflammation using a high sensitivity CRP test
    • Assessment of vitamin D status
    • A TSH to screen for thyroid disorders

The initial treatment includes the following:

  • Adjustment of current medications:
    • Decrease or eliminate medications that cause weight gain
    • Decrease antihypertensive mediations as required to prevent hypotension or
    • Decrease insulin and oral hypoglycemic medications as required to prevent
    • Selective initiation of weight loss medications
  • Exercise prescription and/or referral appropriate to the individual patients readiness for¬†change, physical abilities, and requirement for specialized instruction
  • Selective referral for psychological/psychiatric assessment

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