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It is recommended that the patient partakes in lifestyle modifications if he or she has never participated in such a treatment, before the addition of adjunct therapies such as pharmaceuticals or surgical procedures. If the patient does not successfully lose weight with the lifestyle modifications after a period of time, or if he or she has previously been unsuccessful, or if the patient has a BMI greater than 30 along with a comorbidity, the addition of adjunct therapies may be warranted (Apovian et al., 2015). The medications listed in the above section on pharmaceutical treatments may be prescribed if necessary. If the patient has not responded to behavior modification and has a BMI of over 40 with or without pharmacotherapy, a consultation to a bariatric surgeon may also be ordered (Apovian et al., 2015). Comprehensive education for the patient is a hallmark of the clinical guideline for the treatment of obesity. The patient must first be educated on the proper dietary needs and the aspects of a healthy low-calorie diet plan. The patient may need education regarding the food groups and how to read a nutrition label. The help of a trained nutritionist or dietician to determine the diet plan and to help educate the patient may be necessary. Education may also be given in the form of different ways to increase physical activity safely and adequately, how often to exercise, where to exercise, and what movements to perform. A trainer or exercise physiologist may be incorporated into the treatment plan in order to properly educate and form an exercise plan. If adjunct therapies are needed, the patient will need to be educated about aspects such as pharmaceutical side effects, adverse reactions, cost of medications, and how long
EFFECTS OF OBESITY12and often to take the medications. If bariatric surgery is warranted or if an evaluation is ordered, the patient will need to be educated on the risks and benefits, complications, and costs of the procedure. The patient will often need life-long support and education in order to successfully achieve and maintain weight loss. Standard Practice of Disease ManagementThe standard of practice for the treatment of obesity at Banner Health and the recommended clinical guidelines stated above have both their similarities and differences. The assessment and diagnosis procedures at Banner Health are very similar to the clinical practice guidelines, using essentially the same definition for obesity and standards for surgery recommendations. However, the in-depth investigation into weight-related comorbidities and their causes may be lacking. This may be due to the type of weight loss clinic that Banner Health is, where most patients would likely already have a diagnosis of obesity and may have tried other therapies before being consulted to Banner Health. The Banner Health standard of practice takes mainly a medical approach, itself being a hospital and not a primary care provider.