Before you come

Fast overnight if you can, eight hours, water allowed. It lets us do the bloods the same morning instead of asking you to come back.
Bring every medicine and supplement you take, in the box, including anything ayurvedic, homeopathic or bought without a prescription, and anything you have been taking for weight. Several very common medicines cause weight gain and are easily swapped. We cannot find them if we do not see them.
Bring old reports, however old and however scattered. A sugar reading from four years ago is genuinely useful.
Think about your weight history. When did it start. What was the heaviest. What worked, even briefly, and what happened afterwards. This is the part of the history that most changes the plan.
Bring whoever cooks. If you are not the person who decides what is made in your kitchen, the plan has to be built with the person who does. This one change does more than most prescriptions.

What happens, in order

Measurements Height, weight, waist, hip, blood pressure, and a body composition analysis that separates fat mass from lean mass. This is the baseline everything afterwards is measured against, so it is worth doing carefully.
The history Weight over your life. Family history. Sleep, and specifically snoring, choking at night, and daytime sleepiness, because sleep apnoea is very common in this group and almost never diagnosed. Periods and fertility. Mood and eating pattern, including whether there is binge eating, which changes the plan substantially. Joints. What you have already tried.
The examination Including a look for the things that suggest a hormonal cause rather than a lifestyle one, and for the consequences: acanthosis nigricans, a thyroid, the liver edge, the joints, the feet.
The tests Drawn at Caspian Diagnostic Centre in the same building. What we usually start with is below.
The conversation What your stage is, what the tests are likely to show, what the options are, and what each of them would ask of you. If bloods are still pending, this is where we agree the plan that does not depend on them and book the review that does.

The tests we usually start with

Test	What it is looking for
Fasting glucose and HbA1c	Diabetes and prediabetes. Around one in six Indian adults has prediabetes and most do not know it.
Fasting insulin, where indicated	Insulin resistance, which is usually present long before the sugar moves.
Lipid profile	The Indian pattern is high triglycerides with low HDL rather than very high LDL. It is a specific thing to look for.
Liver function, and ultrasound where indicated	Fatty liver. Present in a large proportion of Indian patients with obesity, and the reason many of them are insulin resistant.
Kidney function	Baseline before any treatment, and because early kidney change is silent.
TSH	Hypothyroidism. It is not usually the cause of obesity, but it is common, easily treated, and needs to be excluded rather than assumed.
Vitamin D and B12	Deficiency is close to the rule rather than the exception in India, and worse on a vegetarian diet.
Complete blood count	Anaemia, which is very common and which will make any exercise plan fail.
Selected hormone tests	Where PCOS, Cushing's or another endocrine cause is suspected, not routinely.

Sleep apnoea deserves a specific mention. If you snore, wake unrefreshed, or your partner has seen you stop breathing, say so at this visit. Untreated sleep apnoea makes weight loss substantially harder, drives blood pressure, and is dangerous in its own right. It is one of the most commonly missed diagnoses in exactly this group of patients, and it is treatable.

What you leave with

Your stage, and what it means.
A written plan covering food, protein, activity and sleep.
Any referrals that are needed.
A follow-up date. For most people the first review is at four weeks.
A clear answer about what treatment options exist for your situation and what each would involve, including what it would cost you every month and for how long.

Your first visit, step by step

Before you come

What happens, in order

The tests we usually start with

What you leave with

Talk to a doctor about your weight

Caspian Healthcare