Skill Checkup: A 43-Year-Old Woman Gains Weight After the Initial Weight Loss Achieved With Diet and Exercise

Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS; Evelyn S. Marienberg, MD


November 14, 2023

Obesity is far more complex than simply eating too much or exercising too little. Many factors lead to the development of obesity, which is why an appropriate next step for this patient is to order standard laboratory studies that include a fasting lipid panel, fasting glucose and HbA1c, liver function studies, and thyroid function tests.

While many patients with excess weight have levels in normal ranges for these laboratory studies, any abnormalities in the results will help to assess underlying comorbidities, such as cardiometabolic syndrome, nonalcoholic steatohepatitis or fatty infiltration of the liver, hypothyroidism, and type 2 diabetes.

Diet, exercise, and behavior modifications should always be part of the approach for patients with excess weight who are highly motivated to manage their obesity and partner with a committed team of healthcare professionals. However, laboratory studies are more likely to provide insight regarding the patient's weight gain.

The patient's laboratory results were normal. Her physician asks if she is open to discussing medication options at their next visit.


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