The safe approach: Frame weight management as part of integrated psychiatric care for your existing patients Pursue additional training (obesity medicine CME, ABOM certification) If you want to make weight management a major service line, get explicit permission in your collaborative agreement (if required) and ensure your collaborating physician has obesity medicine expertise Telehealth Prescribing: Federal Green Lights, State Red Lights The Federal Framework (Through 2025) During COVID-19, the DEA waived the Ryan Haight Act requirement for an in-person exam before prescribing controlled substances
Tachyphylaxis is contingent upon a full 24-hour exposure, as evidenced by a study in which rats treated with liraglutide (with half-life of 11 15 hours) twice daily for 14 days had markedly diminished gastric emptying while those treated with exenatide (with half-life of 2 3 hours) twice daily over the same period still displayed a profound reduction in gastric emptying, although both compounds had similar effects on body weight reduction (158)
The requirements include patients at high metabolic or cardiovascular risk with a BMI greater than 27 with prediabetes or established cardiovascular disease, or a BMI over 30 with uncontrolled hypertension despite treatment, advanced kidney disease, or heart failure
Contamination: Without strict oversight from inspected facilities, there is a risk of bacteria or harmful additives
The FDAs decision limits the disputed risks but does not address the gastrointestinal and vision injury allegations fueling the current litigation
For CKD stages 35 (non-dialysis), the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines typically recommend 0.550.60 g/kg/day (0.60.8 g/kg in diabetes)
