Managing weight loss for a lower BMI patient

Managing weight loss for a lower BMI patient

A weight loss plan using medication for a patient with a BMI of 25 should be approached cautiously, as medications for weight loss are typically indicated for individuals with a BMI of 30 or higher, or for those with a BMI of 27 or higher with an obesity-related comorbidity. However, in some cases, medication may be considered if other weight loss methods have been unsuccessful, and if the patient has a higher risk of weight-related health issues.

The patient should first undergo a medical assessment to evaluate their overall health, including any weight-related comorbidities. The prescriber should review the patient’s medical history, current medications, and potential contraindications for weight loss medications.

Before considering medication, the patient should engage in lifestyle modifications, including dietary changes and increased physical activity. A registered dietitian can help create a personalized meal plan focused on calorie reduction and healthier food choices. An exercise plan, including both aerobic and strength-training exercises, should be done ideally with the guidance of a fitness professional.

Behavioural counselling may be recommended to address eating habits, emotional eating, and other psychological factors contributing to weight gain. For example, cognitive-behavioural therapy (CBT) or other therapeutic approaches could help patients develop healthier relationships with food.

If lifestyle modifications alone are insufficient, weight loss medication options may be considered. Refer to the other lessons within this course that cover the most current prescribed medications. The choice of medication will depend on the patient’s medical history, preferences, and contraindications. Patients prescribed weight loss medications should be closely monitored to assess progress and manage any potential side effects. Regular check-ups and adjustments to the medication dosage may be required.

Continued improvement in diet and a continued focus on increased strength training and aerobic activities should remain a fundamental part of the weight loss plan. If the patient does not plan to be on the medication for life, they should make sure to make fundamental modifications to their lifestyle while on the medication. I.e. they should use the medication as a catalyst for change.

A dietician may also continue to be used especially if dietary changes are necessitated due to medication side effects.

Emotional and psychological support can be essential in helping patients cope with the challenges of weight loss. Support groups or individual therapy can provide valuable assistance.

The patient should be prepared for long-term monitoring and follow-up appointments, even after achieving their weight loss goals. Weight loss medications are typically prescribed for a limited duration, (for example semaglutide is for 2 years) and discontinuation may be recommended once the patient has achieved and maintained their target weight.

The goal is to develop a sustainable plan that promotes long-term health and well-being. The patient should be aware of potential side effects associated with weight loss medications and report any concerns to their clinic immediately. The risks and benefits of weight loss medication should be continuously reviewed for the individual and medication should be seen as a catalyst for lifestyle change rather than an easy way to lose weight.

Please see the Pharmacological Interventions Lesson for more detailed information on Liraglutide, Semaglutide and Tirzepatide.

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