Who this service is for
This weight management consultation with a general practitioner is indicated for adults who:
- Have overweight or obesity and want a complete medical evaluation before starting a weight-loss program
- Gain weight progressively without an apparent cause — especially with fatigue, hair loss, or other associated symptoms
- Have difficulty losing weight despite diet and physical activity — and suspect a hormonal or metabolic cause
- Have type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome — where weight control is an essential part of treatment
- Want an investigation into hormonal causes of weight gain — hypothyroidism, polycystic ovary syndrome, testosterone deficiency
- Want medical evaluation of pharmacological options for weight control — with assessment of indication, contraindications, and risks before any medication
- Need nutritional and physical activity guidance based on their individual clinical profile
- Are foreigners or expats in Brazil with concerns about weight and metabolic health
What is included in the consultation
Complete clinical weight-control evaluation
The doctor performs a complete clinical evaluation — including weight history, current eating pattern, level of physical activity, current medication, family history of obesity and metabolic diseases, and associated symptoms that may suggest an underlying hormonal or metabolic cause.
BMI calculation and metabolic risk assessment
The doctor assesses the Body Mass Index (BMI) and the associated metabolic risk — including cardiovascular risk, risk of type 2 diabetes, and other weight-related comorbidities.
Investigation of hormonal and metabolic causes
Weight gain can have treatable hormonal causes — hypothyroidism, polycystic ovary syndrome, testosterone deficiency, Cushing syndrome, and others. The doctor assesses the suspicion of a hormonal cause based on the symptoms and orders the indicated tests.
Request for metabolic and hormonal tests
The doctor requests the indicated tests for a complete metabolic evaluation — fasting glucose, glycated hemoglobin, lipid profile, thyroid function, fasting insulin, HOMA-IR, uric acid, liver function, and hormonal profile when indicated.
Guidance on diet and physical activity
The doctor provides guidance on dietary and physical activity modifications based on the individual clinical profile — without generic diets or standardized plans that ignore each patient’s specific needs. For more in-depth nutritional guidance, the doctor refers to a nutritionist when indicated.
Assessment of pharmacological options — at the doctor's discretion
Where clinically indicated after a complete assessment of the clinical profile and exclusion of contraindications, the doctor evaluates pharmacological options to help with weight control. No medication can be confirmed or prescribed before the complete clinical evaluation.
Referral to a specialist — when indicated
For severe obesity with indication for bariatric surgery, endocrinopathies requiring specialist evaluation, or the need for more intensive multidisciplinary follow-up, the doctor refers the patient with complete clinical documentation.
Medical causes of weight gain — what to investigate
Not all weight gain is simply a matter of diet and exercise. Several medical conditions can cause or make weight control more difficult — and treating them is the first step toward effective results.
Hypothyroidism
An underactive thyroid reduces basal metabolism and causes progressive weight gain — often accompanied by fatigue, hair loss, constipation, cold intolerance, and dry skin. It is one of the most common and most easily treatable causes of weight gain. Diagnosis is made with TSH and free T4.
Polycystic Ovary Syndrome (PCOS)
PCOS affects approximately 10-15% of women of reproductive age in Brazil and often causes insulin resistance, weight gain — especially abdominal — difficulty losing weight, menstrual irregularity, and acne. Diagnosis requires clinical and laboratory evaluation.
Insulin resistance and prediabetes
Insulin resistance is a very common metabolic condition in Brazil — especially in people with overweight, sedentary lifestyle, family history of diabetes, and metabolic syndrome. It causes progressive weight gain and makes weight loss more difficult. Diagnosis is made with fasting glucose, glycated hemoglobin, and HOMA-IR.
Testosterone deficiency in men
Testosterone deficiency causes loss of muscle mass, increased abdominal fat, fatigue, and difficulty losing weight in men. It is more common than one might think — especially in men over 40 with overweight. Diagnosis is made by measuring total and free testosterone.
Cushing syndrome
Cushing syndrome — caused by excess cortisol — causes characteristic weight gain with abdominal fat, rounded face, purple stretch marks, and muscle weakness. It is less common but important to investigate in patients with this specific pattern of fat distribution.
Use of medications
Several medications cause weight gain as a side effect — including corticosteroids, antidepressants, antipsychotics, anticonvulsants, antihypertensives, and others. The doctor assesses the current medication and its relationship to weight gain.
Pharmacological options for weight control in Brazil
Brazil has a specific pharmacological market for weight control — with some options available that do not exist in other countries and others that exist in other countries but are not registered with ANVISA.
All pharmacological options for weight control require a complete medical evaluation before starting — including assessment of indication, contraindications, cardiovascular history, and other individual risk factors. No weight-control medication can be confirmed or prescribed before the consultation.
GLP-1 analogs — semaglutide and liraglutide
Semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda) are GLP-1 analogs indicated for weight control in adults with obesity or overweight with comorbidities. They have robust scientific evidence for significant weight loss and reduction of cardiovascular risk. They require medical prescription and assessment of contraindications — including personal or family history of medullary thyroid carcinoma and pancreatitis. The doctor assesses the indication during the consultation. Semaglutide — widely known in Brazil by the name Ozempic — has had an explosive increase in use for weight loss in recent years, causing shortages for diabetic patients who depend on the medication. The doctor assesses the actual indication and contraindications before any prescription.
Orlistat
Orlistat works by blocking fat absorption in the intestine. It is one of the options with the longest use and established safety for weight control. Available in Brazil with and without a prescription depending on the dose — the doctor advises on the appropriate dose.
Bupropion associated with naltrexone
The combination of bupropion and naltrexone (Contrave) is indicated for weight control in adults with obesity or overweight with comorbidities. It requires assessment of contraindications — including history of seizures, bipolar disorder, and opioid use.
Topiramate
Topiramate is used off-label for weight control — often in combination with other medications. It requires careful assessment of contraindications and cognitive side effects.
Anfepramone, femproporex and mazindol
These anorectic agents are controlled medications (blue prescription) with historical use in Brazil for weight control. They have restricted and controversial indications — the doctor assesses them based on the individual clinical situation and current guidelines.
Obesity in Brazil — the context
Brazil faces an obesity epidemic — more than 60% of the Brazilian adult population has overweight or obesity, according to data from the Ministry of Health. Obesity is the main modifiable risk factor for type 2 diabetes, cardiovascular disease, hypertension, sleep apnea, and several types of cancer in Brazil.
At the same time, Brazil has one of the highest rates of bariatric surgery in the world — which reflects both the severity of the obesity epidemic and the difficulty of controlling it through conservative means when the problem is not properly addressed in the early stages.
Early medical weight-control evaluation — before overweight progresses to severe obesity — is the most effective and least invasive approach. Teleconsultation removes the access barrier that often delays this evaluation.
