We then need to convince third parties that some patients need to be in the hospital for supervised treatment. This may be more difficult than treating the patient. The increased risk of thromboembolism adds to the need for hospital treatment. Arterial blood gas monitoring and nasal CPAP may be useful. Physical therapy can design and monitor an exercise program to help improve breathing and general strength.
Some patients are so decompensated that they begin treatment on a respirator.
The expense can be great and there can be recurrent admissions unless the cycle is broken by timely and appropriate surgical treatment. There are situations where insufficient communication occurs between those providing emergency care and bariatric surgeons. Instead of an operation for weight control, the patient returns home. Recidivism leads to further emergency admissions. This soon ends in death of the patient with no long-term benefit from the huge medical expense.