# Endo Pharmaco Eligibility

> Assess pharmacotherapy eligibility based on BMI/comorbidity

- Skill: `dromlakhani/endo-pharmaco-eligibility` (Agent Skill)
- Install (CLI): `npx skillmds add dromlakhani/endo-pharmaco-eligibility`
- Raw SKILL.md: https://api.skillmd.com/api/skills/dromlakhani/endo-pharmaco-eligibility/raw
- Safety review: pending (external: skill-scanner PASS, skillspector PASS)
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: dromlakhani (https://skillmd.com/u/dromlakhani)
- Updated: 2026-08-19
- Page: https://skillmd.com/skills/dromlakhani/endo-pharmaco-eligibility

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# Assess pharmacotherapy eligibility based on BMI/comorbidity

## STEP 1 — Gather Information
Collect patient’s current BMI (kg/m2) and screen for obesity‑related comorbidities such as hypertension, dyslipidemia, type 2 diabetes mellitus, obstructive sleep apnea, or cardiovascular disease.

## STEP 2 — Rule In / Rule Out
Is the BMI ≥30 kg/m2?  
- **Yes** → Patient meets pharmacotherapy eligibility regardless of comorbidities → proceed to Step 4.  
- **No** → Proceed to Step 3.

## STEP 3 — Classify or Stratify
Is the BMI between 27 and <30 kg/m2 **and** at least one obesity‑related comorbidity present?  
- **Yes** → Patient meets pharmacotherapy eligibility → proceed to Step 4.  
- **No** → Patient does not meet pharmacotherapy eligibility → proceed to Step 4 (negative).

## STEP 4 — Decide
If eligible: Recommend initiating pharmacotherapy as an adjunct to comprehensive lifestyle modification, after reviewing drug‑specific contraindications and engaging in shared decision‑making.  
If not eligible: Continue lifestyle modification only; reassess eligibility if BMI changes or new comorbidities develop.

## Clinical Guardrails / Mimics / Pitfalls
Do not prescribe pharmacotherapy for BMI <27 kg/m2 without comorbidity; avoid in pregnancy or breastfeeding; screen for contraindications (e.g., uncontrolled hypertension, history of heart disease, glaucoma, MAOI use) before prescribing sympathomimetics; ensure shared decision‑making and document discussion of benefits, risks, and alternatives.

## Concrete Clinical Example
A 45‑year‑old patient presents with BMI 28 kg/m2 and hypertension. BMI is ≥27 and <30 with a comorbidity (hypertension), so the patient qualifies for pharmacotherapy; lifestyle modification plus a weight‑loss medication is offered after discussing options such as orlistat or a GLP‑1 agonist.

**Source:** Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2015, DOI:10.1210/jc.2014-3415