Bariatric Letter

Thank you for referring John Doe. I saw John Doe, aged 45 years, for review of their progress post sleeve gastrectomy on January 15, 2023, at 8 weeks post-surgery. Related issues: John has been experiencing mild nausea and occasional dizziness. Background to condition: John gained weight due to a combination of sedentary lifestyle and high-calorie diet. Anthropometry: Current weight: 95 kg, Height: 175 cm, BMI: 31 kg/m² 15% weight loss from baseline steady weight: 112 kg on November 1, 2022. Down by 17 kg over 3 months. 10% weight loss from weight at the time of surgery: 105 kg on January 15, 2023. Down by 10 kg over 2 months. Expected total weight loss at 12-18 months: 30 kg or 25% Current average weekly rate of weight loss: 1.25 kg/week Previous weight loss attempts: John has tried various diets and exercise programs with limited success. Weight history: Weight history over lifespan: Heaviest adult weight: 120 kg How the patient feels about current body image and weight: John feels more confident and motivated. Dietary assessment: Regularity of eating pattern: Consistent three meals a day Portion sizes: Moderate Comparison of diet against Australian dietary guidelines: Slightly high in fats, needs more vegetables Eating behaviours: Mindful eating, reduced snacking Social: John occasionally drinks socially and does not smoke. Living arrangements: Lives with spouse and two children Employment/study and hours of work: Full-time office job, 40 hours/week Physical activity: Current activity level: Moderate, exercises 3 times a week Past activity level: Low, mostly sedentary How the patient feels about physical activity: Enjoys it and finds it energizing Bowels: Current bowel habits: Regular, once daily Bowel history: No significant issues Client perspective: Why the patient wanted to have the surgery: To improve health and quality of life Current feelings about the surgery and progress: Very satisfied and optimistic Multivitamins: John is compliant with the multivitamin regimen. Medications: Metformin 500 mg twice daily Education: Discussed the importance of balanced diet and regular exercise Written materials provided: Provided a booklet on post-surgery dietary guidelines Plan: Continue current diet and exercise regimen, monitor weight loss progress, and address any nutritional deficiencies. Thank you for your referral. The next review appointment is on April 15, 2023. Feel free to contact me with any questions. I look forward to following up. Kind regards, Dr. Emily Smith