- Lack of physical activity.
- Psychological factors.
- Quickly review lifestyle history for high yield items: juice, fast food, milk, exercise, hobbies/activities, etc.
- If the patient has an elevated BMI, follow every 3-4 months while implementing one lifestyle change at every visit.
- If the BMI > 95, consider a lipid panel and fasting glucose.
- Increase heat production by exercise, hydrotherapy, and massage which will not increase the protein catabolism.
- The use of thyroid extract, attempting to maintain the basic metabolic rate at plus 10 percent.
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