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+--- Thread: bmi ...... - step_three90 (/showthread.php?tid=475463)
bmi ...... - step_three90 - ArchivalUser - 01-06-2010
35 year old femal H/o HTN and obse , Her BMI >35 ........what is the next best step of management .....
a. Behavioral managemnet
b. Pharmacological Management
c. Surgery
0 - ArchivalUser - 01-06-2010
aaaaaa
0 - ArchivalUser - 01-06-2010
considering her previous hx, it'd hv helped to add lab check as an option;- viz lipid profile. ......but since it's not available, i'd lean towards a OR b.
again because of her PMHx, i'd say b.
0 - ArchivalUser - 01-06-2010
if she has been diagnosed with high BP recently, then a, i.e diet and exercise to reduce wt
0 - ArchivalUser - 01-06-2010
why not cccccccc.......surgery??
0 - ArchivalUser - 01-06-2010
before you can get surgery, you have to fail nonsurgical options. So first and foremost its diet/liftestyle changes which would be consistent with a. If she fails this, then you go to other options.
This is pretty common. if you think about it, insurance companies will not pay for gastric bypasses or other surgical options until you have failed conservative management.
0 - ArchivalUser - 01-06-2010
Normal BMI 18.5 - 25
over weight BMI 25- 29.9
obse BMI >30
BMI >25 risk for disease
Management :
BMI > 27 with no Medical comorbiditis = treat with behavioral therapy , dieat and exercise
BMI > 30 or BMI> 27 with Medical comorbiditis = treat with medicine Sibutramine or orlistat.
BMI > 39.9 or BMI > 35 with Medical comorbiditis = is the indication of surgery .
medical comorbiditis : HTN, DM , dyslipidemia ..........
am i worng or right .....??
thank you !
0 - ArchivalUser - 01-06-2010
i haven't read those recommendations. I don't think those reccomendations are ever used in practice. Where is the source?
0 - ArchivalUser - 01-11-2010
you are right stepthree, this person seems to need surgery, tho it seems counterintuitive.
i will go with c.