Obesity Prevention and Management — Comorbidity Assessment and Evaluation — Clinical Pathway: Outpatient Specialty Care and Primary Care
Comorbidity Assessment and Evaluation
NOTE: For most co-morbidities, the primary care provider can refer the patient to Healthy Weight Clinic alone where additional sub-specialty referrals can then be made, if necessary. If primary care provider feels more expedited sub-specialty evaluation is needed or if patient is unable to be seen at Healthy Weight Clinic, referral to appropriate sub-specialists can be made.
Co-morbidities | History | Physical Exam | Additional Evaluation to Consider (if not previously performed) |
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Pre-diabetes and diabetes | Family history | Acanthosis nigricans |
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Hypertension | Family history | Accurately measured BP percentile |
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Dyslipidemia | Family history | Xanthomas |
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Sleep Apnea | Sleep Apnea Verbal Screen Snoring Labored breathing Observed pauses in breathing Fatigue/Daytime sleepiness Learning/Behavior problems Bedwetting (Nocturnal Enuresis) Family History of OSA |
Enlarged tonsils Loud nasal breathing/frequent mouth breathing |
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NAFLD/NASH | Mostly Asymptomatic; RUQ abdominal pain | Hepatomegaly RUQ tenderness to palpation |
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Slipped Cap Femoral Epiphysis (SCFE) and Juvenile Osteochondritis (aka Blount's Disease) |
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Polycystic Ovarian Syndrome (PCOS) | PCOS verbal screen | Hirsutism Acne Acanthosis Nigricans |
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Pseudotumor Cerebri Syndrome (PTCS) | PTCS verbal screen | Papilledema |
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Psychosocial |
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Vitamin D Deficiency | Family history Nutritional intake |
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Other conditions to consider that can cause overweight/obesity | History | Physical Exam | Additional Evaluation to Consider (if not previously performed) |
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Hypothyroidism |
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Enlarged thyroid gland (may or may not be present) |
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Cushing's Disease | Family History |
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Referral(s) to: Endocrinology |
Genetic Disorders |
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Medications that can cause weight gain:
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