Table 2 : Drugs available as adjuncts to diet and exercise for the treatment of obesity ( continued ..)
Generic name ( Brand Name ) |
Usual dosing ( adults ) |
US DEA Schedule |
Noradrenergic sympathomimetic drugs approved for short term use ( 12 weeks or less ) |
Benzphetamine |
Initial : 25mg once daily : may titrate up to 25 mg or
C-III
|
( Didrex , Regimex ) |
50 mg one to three times daily . |
Maximum dose : 50 mg three times daily . |
Diethylpropion ( Depletite , Durad , Radtue , Tenuate , Tenuate Dospan )
Immediate release : 25 mg three times daily before meals . Extended release : 75 mg every morning .
Phentermine Immediate release : 15 to 37.5 mg daily or divided ( Adipex-P , Atti-Plex twice daily . Orally disintegrating tablets ( ODT ): 15 P , Atti-Plex P to 37.5 mg once daily in the morning . Spansule , Fastin , Lomaira , Pro-Fast , Suprenza , Tara-8 ) Phendimetrazine ( Bock-Arate , Bontril PDM , Bontril SR , Melfiat 105 Unicelles , Prelu-2 , Rapdone , Stabec-1 )
Immediate release : 17.5 to 35 mg two or three times daily , one hour before meals . Maximum dose : 70 mg three time daily . Sustained release : 105 mg daily in the morning
C-IV
C-IV
C-III
Adverse effects / precautions
Applies to all sympathomimetic agents ; due to their side effects and potential for abuse , we suggest not prescribing sympathomimetics for weight loss . If prescribed , limit to short term (< 12 weeks ) use . Adverse effects include increase in heart rate , blood pressure , insomnia , dry mouth , constipation , nervousness . Abuse potential due to amphetamine-like effects . May counteract effect of blood pressure medications . Avoid in patients with heart disease , poorly controlled hypertension , pulmonary hypertension or history of addiction or drug abuse . Contraindicated in patients with a history of CVD , hyperthyroidism , MAO inhibitor therapy , agitated states , pregnancy or breastfeeding .
Table 3 : Body Mass Index with ICD Codes A full BMI index can be viewed at https :// www . mountcarmelhealthpartners . com / pdfs / bmi-chart . pdf .
Underweight Normal Range Overweight
BMI < 19 19 20 21 22 23 24 25 26 27 28 29
ICD-10 Z68.1 Z68.1 Z68.20 Z68.21 Z68.22 Z68.23 Z68.24 Z68.25 Z68.26 Z68.27 Z68.28 Z68.29
Obese
BMI ICD-10
30 31 32 33 34 35 36 37 38 39 Z68.30 Z68.31 Z68.32 Z68.33 Z68.34 Z68.35 Z68.36 Z68.37 Z68.38 Z68.39
Extreme Obesity
BMI
ICD-10
40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
Z68.41 Z68.42 Z68.43
Extreme Obesity
BMI
ICD-10
60 61 62 63 64 65 66 67 68 69 70 > 70
Z68.44 Z68.45
Table 4 : Institute of Medicine Weight Gain Recommendations for Pregnancy
Pregnancy Weight Category Body Mass Index
Recommended Range of Total Weight ( lb )
Recommended Rates of Weight Gain * in the Second and Third Trimesters ( lb ) ( Mean Range [ lb / wk ])
Underweight Less than 18.5 28-40 1 ( 1-1.3 ) Normal Weight 18.5-24.9 25-35 1 ( 0.8-1 )
Overweight 25-29.9 15-25 0.6 ( 0.5-0.7 ) Obese ( includes all classes ) 30 and greater 11-20 0.5 ( 0.4-0.6 )
* Calculations assume a 1.1-4.4 lb . weight gain in the first trimester .
Adult Obesity - 4