Assess

Severity of obesity with calculated BMI, waist circumference, and comorbidities

Food intake and physical activity in context of health risks and appropriate dietary approach

Medications that affect weight or satiety

Readiness to change behavior and stage of change

Advise

Diagnosis of overweight, obese, or severe obesity

Caloric deficit needed for weight loss

Various types of diets that lead to weight loss and ease of adherence

Appropriateness, cost, and effectiveness of meal replacements, dietary supplements, over-the-counter weight aids, medications, surgery

Importance of self-monitoring

Agree

If patient is not ready, discuss at another visit

If patient is motivated and ready to change, develop treatment plan

If patient chooses diet, physical activity, and/or medication, set weight loss goal 10% from baseline

If patient is a potential candidate for surgery, review the options

Assist

Provide a diet plan, physical activity guide, and behavior modification guide

Provide Web resources based on patient interest and need

Identify method for self-monitoring (eg, diary)

Review food and activity diary on follow-up. (Reassess if initial goal is not met.)

Arrange

Follow-up appointments to meet patient needs

Referral to registered dietitian and/or behavioral specialist for individual counseling/monitoring or weight management class

Referral to surgical program

Maintenance counseling to prevent relapse or weight regain