Endo Followup Assessment

---
name: endo-followup-assessment
description: Advises assessing efficacy and safety at least monthly for the first 3 months, then at least every 3 months for all patients prescribed weight‑loss medications. Triggers include clinician questions such as “How often should I check progress after starting orlistat?” or “What is the follow‑up schedule for a patient on liraglutide?”.
---

# Schedule follow‑up assessments for weight‑loss medications

## STEP 1 — Gather Information
Record the specific weight‑loss medication, start date, baseline weight, comorbidities, and baseline safety labs (e.g., LFTs for orlistat, renal function for GLP‑1 agonists).

## STEP 2 — Rule In / Rule Out
Determine whether the patient is ≤3 months or >3 months since initiating the weight‑loss medication; if ≤3 months go to Step 3A, if >3 months go to Step 3B.

## STEP 3 — Classify or Stratify
If ≤3 months: set follow‑up interval to 1 month; if >3 months: set follow‑up interval to 3 months.

## STEP 4 — Decide
Schedule the next clinical visit according to the assigned interval and document the plan in the medical record.

## Clinical Guardrails / Mimics / Pitfalls
- Do not rely on patient‑reported weight alone; obtain objective measurements each visit.  
- Monitor medication‑specific adverse effects (e.g., GI intolerance with orlistat, nausea/vomiting with GLP‑1 agonists, psychiatric symptoms with bupropion/naltrexone).  
- Avoid extending follow‑up beyond recommended intervals without reassessment of efficacy and safety.  
- Consider early discontinuation if <5% weight loss at 3 months or if safety/tolerability issues arise.

## Concrete Clinical Example
A 48‑year‑old man begins orlistat 120 mg TID. At baseline he weighs 110 kg. At 4‑week visit he has lost 2 kg and reports mild oily stools; still within first 3 months, so next visit is scheduled in 1 month. At the 3‑month visit he has lost 5 kg (4.5% of baseline) with no new adverse effects; because he is now >3 months, follow‑up is set to every 3 months.

**Source:** Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2015, DOI:10.1210/jc.2014-3415