Patient Background:
Mr. C is a 52-year-old male with a BMI of 37 kg/m² and a 10-year history of obesity with multiple prior attempts at sustained weight loss through calorie restriction and exercise.
Comorbidities include hypertension (amlodipine 10 mg), dyslipidemia (atorvastatin 40 mg), prediabetes (HbA1c 6.2%), and obstructive sleep apnea managed with CPAP. He is a non-smoker. Family history includes paternal myocardial infarction at age 58. He is motivated for pharmacologic intervention and has enrolled in a structured lifestyle program.
Assessment & Diagnosis:
Waist circumference: 116 cm. BP: 138/86 mmHg. Fasting glucose: 108 mg/dL. LDL-C: 118 mg/dL.…read more
He is an appropriate candidate for chronic weight management therapy. Treatment selection was guided by shared decision-making, cardiometabolic risk profile, prior weight-management history, and patient preference.
The care team initiates a once-weekly subcutaneous GLP-1 receptor agonist with gradual dose escalation over 16–20 weeks to improve tolerability.
In the STEP 1 trial (n=1,961), participants treated with semaglutide achieved a mean weight loss of 14.9% vs 2.4% with placebo at 68 weeks (p<0.001).
Common adverse effects discussed with the patient include nausea, vomiting, diarrhea, and constipation, particularly during dose escalation.
- Please provide a minimum of a 3 sentence response.
- 1.Which comorbidities support GLP-1 RA therapy in this patient?
- 2.What counseling strategies help minimize GI adverse effects during GLP-1 RA dose escalation?
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JOEL WASHINSKY2dObesity, hyperlipidemia, prediabetes and hypertension. I give the patients a script for Zofran prophylactically. Advise very small portions. -
Mike Shirk2moPatient's bmi over 27 support us of GLP-1. Also pt is prediabetic and GLP-1 should have a great impact on sugars. Furthermore, his Obstructive Show More
