Total calorie intake and proportions of fat, carbohydrate, and protein should be reviewed. Obtaining a history of previous weight-loss attempts is important. Results of these efforts and reasons for initiating them should be noted. It is helpful to discuss with the patient why he is seeking to lose weight now and what his expectations are for the amount of weight loss and the time period to achieve it. This discussion provides insight into motivation and realism of expectations and provides an opportunity to set goals for specified behavior changes.
Obesity is a chronic illness.
Dietary changes and exercise can be effective but require a dedicated team approach, with ongoing re-evaluation of attempts to change behavior. Pharmacologic options are currently limited. None of the agents available at present are without potential side effects. Because of the recent concerns that led some diet drugs to be taken off the market, many practitioners are understandably reluctant to try new agents without substantial evidence supporting safety. Surgical procedures for obesity are usually reserved for the morbidly obese.