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Phil McElnay

Created on January 7, 2026

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Transcript

The Clinical Challenge

Meet Maria

History

Examination

Past Medical History

Medications

Key Questions:

What if my patient is not responding to treatment?

What if my patient is not responding to treatment?

What if my patient is not responding to treatment?

Expert Insights

Key Messages

Utilize evidence-based strategies to initiate and continue long term treatment of obesity.

Longitudinal follow up and support are integral to long-term adherence and treatment success!

The focus of obesity management should be the improvement of health parameters (metabolic, mechanical, mental, and/or quality of life), not solely weight reduction, and should include outcomes that the patient identifies as important.

Toolkit

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Take Home Messages

The focus of obesity management should be the improvement of health parameters (metabolic, mechanical, mental, and/or quality of life), not solely weight reduction, and should include outcomes that the patient identifies as important.

The focus of obesity management should be the improvement of health parameters (metabolic, mechanical, mental, and/or quality of life), not solely weight reduction, and should include outcomes that the patient identifies as important.

Title

Title

Use this side to give more information about a topic.

Use this side to give more information about a topic.

Focus of obesity management

Evidence-based strategies

Subtitle

Subtitle

Medications

irbesartan 150 mg OD, amlodipine 10mg OD, levothyroxine 125mcg OD, semaglutide 2.4mg weekly, paracetamol prn for pain

History

Maria, 45, office assistant.

  • She has come in to discuss her recent lab work which reveals prediabetes. Weight struggle began after having her first child (has two)
  • Has tried lifestyle approaches on her own
  • Has felt blame and shame around her weight from family and from HCPs in the past
  • A little improvement in knee pain
  • OSA now high moderate (27 events/h)
  • Weight loss 4.8% and has plateaued
  • A little improvement in knee pain
  • OSA now high moderate (27 events/h)
  • Weight loss 4.8% and has plateaued
  • A little improvement in knee pain
  • OSA now high moderate (27 events/h)
  • Weight loss 4.8% and has plateaued

Examination

BMI 35, waist circumference 105 cm Waist to height ratio = 0.6 BP 118/72 Otherwise normal

Past Medical History
  • Severe obstructive sleep apnea (31 events/h) – doesn’t tolerate CPAP
  • Knee osteoarthritis
  • Hypertension, controlled
  • Hypothyroidism
  • Obesity