Wegovy Hd

Drug overview for WEGOVY HD (semaglutide):

Generic name: SEMAGLUTIDE (SEM-a-GLOO-tide)
Drug class: Diet Aids
Therapeutic class: Weight Loss/Gain Agents

Semaglutide, a synthetic, long-acting glucagon-like peptide-1 (GLP-1) receptor agonist (incretin mimetic), is an antidiabetic agent.

No enhanced Uses information available for this drug.

DRUG IMAGES

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The following indications for WEGOVY HD (semaglutide) have been approved by the FDA:

Indications:
Cardiovascular event risk reduction in obesity
Nonalcoholic steatohepatitis
Weight loss management for obese patient (body mass index 30 or greater)
Weight loss management for overweight patient with weight-related comorbidity

Professional Synonyms:
MASH
Metabolic dysfunction-associated steatohepatitis
NASH

Dosing information for WEGOVY HD
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
WEGOVY HD 7.2 MG/0.75 ML PEN	Maintenance	Adults inject 7.2 mg by subcutaneous route once weekly on the same day of each week

The following drug interaction information is available for WEGOVY HD (semaglutide):

Contraindicated
Severe
Moderate

There are 0 contraindications.

There are 1 severe interactions. These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.

Drug Interaction	Drug Names
Antidiabetic Agents/Gatifloxacin SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: The exact mechanism is unknown. CLINICAL EFFECTS: Concurrent use of gatifloxacin may result in hypoglycemia and/or hyperglycemia.(1-4) Hypoglycemia is more common during the first three days of concurrent therapy. Hyperglycemia is more common after the first three days of concurrent therapy.(2) PREDISPOSING FACTORS: Elderly patients, especially those with decreased renal function may be predisposed to this interaction.(2) PATIENT MANAGEMENT: Patients receiving concurrent gatifloxacin should be closely monitored for hypoglycemia during the first three days of concurrent therapy and for hyperglycemia after the first three days of concurrent therapy. Patients should be instructed to discontinue gatifloxacin if hypoglycemia or hyperglycemia occur.(2) DISCUSSION: Hypoglycemia has been reported with gatifloxacin and glyburide(1,5,6) or glimepiride.(7) In a study in patients with type 2 diabetes mellitus, concurrent gatifloxacin (400 mg daily for 10 days) had no effect on the pharmacokinetics of glyburide (steady state daily regimen); however, pharmacodynamic interactions have been reported.(2) Health Canada has received 19 reports of hypoglycemia in patients taking gatifloxacin. Seventeen of these involved concurrent hypoglycemic agents. Health Canada has received 2 reports of hyperglycemia in patients taking gatifloxacin and hypoglycemic agents. Health Canada has received 2 reports of patients experiencing hypoglycemia and hyperglycemia during concurrent gatifloxacin and hypoglycemic agents.(3) In a study, 13 reports of dysglycemia were reported in patients taking gatifloxacin. Ten of these patients had diabetes mellitus and were on concurrent hypoglycemic agents. Of these ten patients, nine patients experienced hypoglycemia, while one patient experienced hyperglycemia.(8)	GATIFLOXACIN SESQUIHYDRATE

Drug Interaction

Drug Names

Antidiabetic Agents/Gatifloxacin

SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.

MECHANISM OF ACTION: The exact mechanism is unknown.

CLINICAL EFFECTS: Concurrent use of gatifloxacin may result in hypoglycemia and/or hyperglycemia.(1-4) Hypoglycemia is more common during the first three days of concurrent therapy. Hyperglycemia is more common after the first three days of concurrent therapy.(2)

PREDISPOSING FACTORS: Elderly patients, especially those with decreased renal function may be predisposed to this interaction.(2)

PATIENT MANAGEMENT: Patients receiving concurrent gatifloxacin should be closely monitored for hypoglycemia during the first three days of concurrent therapy and for hyperglycemia after the first three days of concurrent therapy. Patients should be instructed to discontinue gatifloxacin if hypoglycemia or hyperglycemia occur.(2)

DISCUSSION: Hypoglycemia has been reported with gatifloxacin and glyburide(1,5,6) or glimepiride.(7) In a study in patients with type 2 diabetes mellitus, concurrent gatifloxacin (400 mg daily for 10 days) had no effect on the pharmacokinetics of glyburide (steady state daily regimen); however, pharmacodynamic interactions have been reported.(2) Health Canada has received 19 reports of hypoglycemia in patients taking gatifloxacin.

Seventeen of these involved concurrent hypoglycemic agents. Health Canada has received 2 reports of hyperglycemia in patients taking gatifloxacin and hypoglycemic agents. Health Canada has received 2 reports of patients experiencing hypoglycemia and hyperglycemia during concurrent gatifloxacin and hypoglycemic agents.(3)

In a study, 13 reports of dysglycemia were reported in patients taking gatifloxacin. Ten of these patients had diabetes mellitus and were on concurrent hypoglycemic agents. Of these ten patients, nine patients experienced hypoglycemia, while one patient experienced hyperglycemia.(8)

GATIFLOXACIN SESQUIHYDRATE

There are 4 moderate interactions. The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.

Drug Interaction	Drug Names
Selected Antidiabetic Agents/Selected Quinolones SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: The exact mechanism is unknown. CLINICAL EFFECTS: Concurrent use of quinolones and antidiabetic agents may result in severe hypoglycemia.(1-7) Hypoglycemia can lead to coma. PREDISPOSING FACTORS: Elderly patients, especially those with decreased renal function may be predisposed to this interaction.(5) PATIENT MANAGEMENT: Patients maintained on antidiabetic agents who require concurrent therapy with a quinolone should be closely monitored for hypoglycemia.(1-4) Patients should be instructed to discontinue quinolone use and contact their doctor if hypoglycemia occurs.(2,4) Signs of hypoglycemia may include confusion, dizziness, feeling shaky, unusual hunger, headaches, irritability, pounding heart or very fast pulse, pale skin, sweating, trembling, weakness, or unusual anxiety. DISCUSSION: Hypoglycemia has been reported with concurrent ciprofloxacin and glyburide,(1,8,9) levofloxacin and glyburide,(2,10,11) norfloxacin and glyburide,(3) levofloxacin and glipizide (12) as well as levofloxacin and metformin-glibenclamide.(14) There has been one report of fatal hypoglycemia with concurrent levofloxacin and glyburide(9) and one of the above reports of hypoglycemia with concurrent levofloxacin and glyburide resulted in hypoxic brain injury.(11) A review of postmarketing adverse event data for the fluoroquinolones and hypoglycemic coma identified 56 reports in FAERS search from October 1987- April 2017 and 11 additional cases in the medical literature. Most patients had risk factors for hypoglycemia. 41 patients were taking one or more hypoglycemic drugs. 13 deaths occurred (some of these patients had renal insufficiency). 9 patients did not fully recover and had resultant disability.(13)	BAXDELA, CIPRO, CIPROFLOXACIN, CIPROFLOXACIN HCL, CIPROFLOXACIN-D5W, LEVOFLOXACIN, LEVOFLOXACIN HEMIHYDRATE, LEVOFLOXACIN-D5W, MOXIFLOXACIN, MOXIFLOXACIN HCL, OFLOXACIN
Selected Antidiabetic Agents/Chloroquine; Hydroxychloroquine SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: The exact mechanism is unknown. Chloroquine and hydroxychloroquine may increase insulin sensitivity by inhibiting insulin metabolism and inflammation and increasing cellular uptake of glucose and glycogen synthesis.(1,2) These effects may result in additive hypoglycemia with anti-diabetic agents. CLINICAL EFFECTS: Concurrent use of chloroquine or hydroxychloroquine and antidiabetic agents may result in severe hypoglycemia.(3) Hypoglycemia can lead to coma. PREDISPOSING FACTORS: Elderly patients, especially those with decreased renal function may be predisposed to this interaction. PATIENT MANAGEMENT: Patients maintained on antidiabetic agents who require concurrent therapy with chloroquine or hydroxychloroquine should be closely monitored for hypoglycemia. A decrease in the dose of insulin or other anti-diabetic medications may be required. Patients should be advised of the risk and symptoms of hypoglycemia and to contact their doctor if hypoglycemia occurs.(3) Signs of hypoglycemia may include confusion, dizziness, feeling shaky, unusual hunger, headaches, irritability, pounding heart or very fast pulse, pale skin, sweating, trembling, weakness, or unusual anxiety. DISCUSSION: Hydroxychloroquine has been shown to cause severe hypoglycemia including loss of consciousness that could be life threatening.(3) Concomitant hypoglycemic agents may increase the risk and/or severity of this effect. A 77 year old man who was stable on twice daily insulin suffered two episodes of hypoglycemic coma 2 weeks after starting prednisone 5 mg daily and hydroxychloroquine 400 mg daily for rheumatoid arthritis. His insulin dosage required a decrease of 37%.(4) Many studies have investigated the glucose-lowering effect of hydroxychloroquine. In a clinical trial of type II diabetics on maximal doses of sulfonylureas, addition of hydroxychloroquine lowered hemoglobin A1C (HbA1C) up to 1% more than placebo.(5) Another clinical trial of type II diabetics on metformin and glimepiride or gliclazide found that hydroxychloroquine 400 mg daily reduced fasting blood glucose (FBG), post-prandial glucose (PPG), and HbA1C to a similar degree as pioglitazone 15 mg daily at 24 weeks.(6) In a prospective observational study, 250 uncontrolled type II diabetics on metformin, glimepiride, pioglitazone, sitagliptin, and a SGLT-2 inhibitor received hydroxychloroquine 400 mg daily for 48 weeks. HbA1C decreased from 8.83% to 6.44%, FBG decreased by 40.78%, and PPG decreased by 58.95%. The doses of metformin were reduced by 50%, glimepiride and sitagliptin by 75%, and SGLT-2 inhibitors were discontinued in most patients.(7)	CHLOROQUINE PHOSPHATE, HYDROXYCHLOROQUINE SULFATE, PLAQUENIL, SOVUNA
Thyroid Preparations/GLP-1 Receptor Agonists SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: The exact mechanism is unknown but may be related to decreased GI motility resulting in increased absorption of levothyroxine. Weight loss may also cause stable doses of levothyroxine to be too high for weight-based dosing.(1) CLINICAL EFFECTS: Concurrent administration of GLP-1 receptor agonists and thyroid preparations may increase the clinical effects of the thyroid agent, resulting in symptoms of hyperthyroidism.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients taking thyroid preparations and GLP-1 receptor agonists should be monitored for changes in thyroid function. Symptoms of hyperthyroidism include weight loss, rapid heartbeat, nervousness, sweating, tremor, fatigue, and difficulty sleeping. The dosage of levothyroxine may need to be adjusted accordingly. DISCUSSION: In an open-label, one-sequence, crossover, 2-part trial examining the effect of administering 14 mg oral semaglutide and levothyroxine together, a 33% increase in levothyroxine AUC was identified. The trial also examined the impact of SNAC , the absorption enhancer in oral GLP-1 receptor agonists, and found that SNAC alone did not impact absorption of levothyroxine.(2) In a single-center, prospective trial, participants with diabetes without thyroid disease were given exenatide and TSH levels were measured. After 6 months of treatment, mean TSH concentration decreased from 2.3 to 1.8 without impact to T4 and T3. The mechanism that was proposed was that exenatide can increase the sensitivity of the hypothalamus or pituitary gland to the thyroid hormone negative feedback or increase the number of receptors on the hypothalamus or pituitary gland. No relationship was found between weight change and TSH level.(3) In a case report, a post-thyroidectomy patient on a stable dose of levothyroxine (125 mcg daily) started concurrent subcutaneous semaglutide therapy. Five months after starting treatments together, she started experiencing palpitations, perspiration, and heat intolerance. The levothyroxine dose was decreased to 88 mcg daily resulting in a resolution of symptoms.(4) In another case report, a 43-year-old female patient was on a stable dose of levothyroxine (200 mcg) and started on subcutaneous semaglutide. After 5 months, her TSH level dropped to 0.01 ng/dL and levothyroxine was reduced to 150 mcg daily.(5)	ADTHYZA, ARMOUR THYROID, CYTOMEL, EVEXITHROID, LEVO-T, LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM DILUTION, LEVOXYL, LIOMNY, LIOTHYRONINE SODIUM, NIVA THYROID, NP THYROID, PCCA T3 SODIUM DILUTION, PCCA T4 SODIUM DILUTION, RENTHYROID, SYNTHROID, THYQUIDITY, THYROID, TIROSINT, TIROSINT-SOL, UNITHROID
Anesthesia Agents/GLP-1 Receptor Agonists SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: GLP-1 receptor agonists can cause delayed gastric emptying.(1,2) CLINICAL EFFECTS: Gastric contents may remain in the stomach after preoperative fasting, which could increase the risk of regurgitation and aspiration.(1,2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The American Society of Anesthesiologists (ASA) recommends the following for patients receiving elective procedures: - For patients on daily dosing, consider holding GLP-1 agonists on the day of the procedure. For patients on weekly dosing, consider holding GLP-1 agonists a week prior to the procedure. - Consult an endocrinologist for patients taking GLP-1 agonists for diabetes management if the GLP-1 agonist is held longer than the dosing schedule to avoid hyperglycemia. - For patients requiring urgent or emergent procedures, proceed and treat the patient as 'full stomach.'(3) DISCUSSION: In one case report, a 31-year-old patient taking semaglutide followed preoperative fasting guidelines but food residue was discovered upon endoscopy, leading to cancellation of the surgical procedure.(4) In a case report, a semaglutide-treated patient experienced regurgitation upon induction of general anesthesia despite a 20 hour preoperative fasting period. The patient received semaglutide two days before the scheduled procedure.(5) A case report of a 42-year-old patient after fasting for 18 hours showed substantial gastric content upon endoscopy. The patient experienced intraoperative pulmonary aspiration of gastric contents which were suctioned from the trachea and bronchi using bronchoscopy.(6)	AMIDATE, ANECTINE, ATRACURIUM BESYLATE, BREVITAL SODIUM, CISATRACURIUM BESYLATE, DESFLURANE, DEXMEDETOMIDINE HCL, DEXMEDETOMIDINE-0.9% NACL, DEXMEDETOMIDINE-D5W, DIPRIVAN, ETOMIDATE, FORANE, ISOFLURANE, METHOHEXITAL SODIUM, METHOHEXITAL-STERILE WATER, PRECEDEX, PROPOFOL, QUELICIN, SEVOFLURANE, SUCCINYLCHOLINE CHLORIDE, SUCCINYLCHOLINE CHLORIDE-NACL, SUPRANE, TERRELL, ULTANE, VECURONIUM BROMIDE, VECURONIUM BROMIDE-WATER

The following contraindication information is available for WEGOVY HD (semaglutide):

Overview
Contraindicated
Severe
Moderate

Drug contraindication overview.

*Patients with personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). *Patients with prior serious hypersensitivity reaction to semaglutide or any ingredient in the formulation.

There are 1 contraindications. Absolute contraindication.

Contraindication List
Acute pancreatitis

There are 4 severe contraindications. Adequate patient monitoring is recommended for safer drug use.

Severe List
Family history of medullary thyroid carcinoma
Gastroparesis
Medullary thyroid carcinoma
Multiple endocrine neoplasia type 2

There are 4 moderate contraindications. Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.

Moderate List
Diabetic retinopathy
Hypoglycemic disorder
Kidney disease with likely reduction in glomerular filtration rate (GFr)
Kidney disease with reduction in glomerular filtration rate (GFr)

The following adverse reaction information is available for WEGOVY HD (semaglutide):

Overview
Severe
Less Severe

Adverse reaction overview.

Adverse effects reported in at least 5% of patients receiving subcutaneous semaglutide (Ozempic(R)) in placebo-controlled clinical trials include nausea, vomiting, diarrhea, abdominal pain, and constipation. Adverse effects reported in at least 5% of patients receiving oral semaglutide in placebo-controlled clinical trials include nausea, abdominal pain, diarrhea, decreased appetite, vomiting, and constipation. Adverse effects reported in at least 5% of patients receiving subcutaneous semaglutide (Wegovy(R)): nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation, hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis.

There are 12 severe adverse reactions.

More Frequent	Less Frequent
None.	Hypoglycemic disorder

Rare/Very Rare
Acute kidney injury Acute pancreatitis Anaphylaxis Angioedema Appendicitis Biliary calculus Cholecystitis Gastrointestinal obstruction Ileus Kidney disease with reduction in glomerular filtration rate (GFr) Necrotizing pancreatitis

There are 31 less severe adverse reactions.

More Frequent	Less Frequent
Acute abdominal pain Diarrhea Gastroenteritis Headache disorder Nausea Pharyngitis Vomiting	Dyspepsia Eructation Fatigue Flatulence Gastroesophageal reflux disease Influenza Sinusitis

Rare/Very Rare
Alopecia Constipation Dizziness Dysesthesia Dysgeusia Elevated serum amylase Elevated serum lipase Fecal impaction Gastritis Hemorrhoids Hiccups Injection site sequelae Photophobia Skin rash Tachycardia Urolithiasis Urticaria

The following precautions are available for WEGOVY HD (semaglutide):

Pediatric
Pregnant
Lactation
Geriatric

Safety and efficacy of semaglutide for type 2 diabetes mellitus (Ozempic(R), Rybelsus(R)) have not been established in children or adolescents <18 years of age. The safety and efficacy of semaglutide (Wegovy(R)) as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management have been established in pediatric patients >=12 years of age with a BMI corresponding to >=95th percentile standardized for age and sex. Use of semaglutide for this indication is supported by a 68-week, double-blind, placebo-controlled clinical trial in pediatric patients and from studies in adult patients with obesity.

There are insufficient data in pediatric patients with type 2 diabetes treated with Wegovy(R) for obesity to determine if there is an increased risk of hypoglycemia with the drug similar to that reported in adults. Inform patients of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia. When initiating Wegovy(R) in pediatric patients >=12 years of age with type 2 diabetes, consider reducing the dose of the concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

Data are lacking on the use of semaglutide in pregnant women. However, reproduction studies in animals have shown teratogenic effects. Poorly controlled diabetes mellitus during pregnancy increases maternal risk for diabetic ketoacidosis, pre-eclampsia, spontaneous abortion, preterm delivery, and delivery complications.

In addition, poorly controlled diabetes mellitus during pregnancy increases the risk of major fetal birth defects, stillbirth, and macrosomia-related morbidity. Embryofetal mortality, structural abnormalities (e.g., visceral and skeletal abnormalities), and alterations to growth were observed in the offspring of rats who were administered semaglutide during organogenesis at dosages resulting in systemic exposures lower than the maximum recommended human dosage. In reproduction studies in rabbits and monkeys, early pregnancy loss and structural abnormalities (e.g., visceral and skeletal abnormalities) were observed at dosages below the maximum recommended human dosage and at dosages at least 5 times greater than the maximum recommended human dosage.

Salcaprozate sodium (SNAC), an absorption enhancer contained in semaglutide oral tablets, crosses the placenta and reaches fetal tissues in rats. In a prenatal and postnatal development study in pregnant Sprague Dawley rats, SNAC was administered orally at 1000 mg/kg per day (exposure levels were not measured) on gestation day 7 through lactation day 20. An increase in the length of gestation and number of stillbirths and a decrease in pup viability were observed.

The manufacturers of the semaglutide preparations used for diabetic management state the drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Semaglutide should be discontinued in women for at least 2 months before a planned pregnancy due to the drug's long half-life. The manufacturer of the semaglutide preparation used for weight control management states that weight loss offers no benefit to a pregnant patient and may cause fetal harm; if a patient becomes pregnant while receiving the drug, treatment should be discontinued. A pregnancy exposure registry has been established to monitor pregnancy outcomes in women exposed to Wegovy(R); encourage pregnant women exposed to the drug to contact 1-800-727-6500.

Semaglutide is distributed into milk in rats at concentrations 3-12 fold lower than in maternal plasma. It is not known whether semaglutide is distributed into milk in humans or what the effects of the drug are on the breast-fed infant or on milk production. The benefits of breast-feeding and the importance of semaglutide to the woman should be considered along with any potential adverse effects on the breast-fed infant from the drug or from the underlying maternal condition.

SNAC, an absorption enhancer contained in semaglutide oral tablets, and/or its metabolites are concentrated in the milk of lactating rats. SNAC and/or its metabolites were detected in milk of lactating rats following a single maternal administration on lactation day 10. Mean levels of SNAC and/or its metabolites in milk were approximately 2-12 fold higher than in maternal plasma.

There are no data on the presence of SNAC in human milk; however, substances present in animal milk are likely to be present in human milk. Since the activity of UGT2B7, an enzyme involved in SNAC clearance, is lower in infants than in adults, higher SNAC plasma concentrations may occur in neonates and infants. Because of the unknown potential for serious adverse reactions in the breast-fed infant due to the possible accumulation of SNAC from breast-feeding and because there are alternative formulations of semaglutide (e.g., injection) that can be used during lactation, patients should be advised that breast-feeding is not recommended during treatment with oral semaglutide.

In the pool of placebo- and active-controlled glycemic control clinical trials, 23.6% of patients receiving subcutaneous semaglutide and 29.9% of those receiving oral semaglutide were 65 years of age and older; 3.2%

of those receiving subcutaneous semaglutide and 4.8% of those receiving oral semaglutide were 75 years of age and older. In a cardiovascular outcome trial (SUSTAIN-6) of subcutaneous semaglutide, 48% of patients were 65 years of age and older and 9.6%

were 75 years of age and older; in a cardiovascular outcomes trial of oral semaglutide (PIONEER 6), 43.4 or 12.3% of patients were at least 65 or at least 75 years of age, respectively.

In the trials of subcutaneous semaglutide (Wegovy), 8.8% of patients receiving the drug were 65-75 years of age and 0.9% were >=75 years of age. No substantial differences in safety and efficacy relative to younger adults were observed in these patients, but increased sensitivity in some geriatric individuals cannot be ruled out.

The following icd codes are available for WEGOVY HD (semaglutide)'s list of indications:

Cardiovascular event risk reduction in obesity
E66.01	Morbid (severe) obesity due to excess calories
E66.09	Other obesity due to excess calories
E66.1	Drug-induced obesity
E66.2	Morbid (severe) obesity with alveolar hypoventilation
E66.3	Overweight
E66.8	Other obesity
E66.81	Obesity class
E66.811	Obesity, class 1
E66.812	Obesity, class 2
E66.813	Obesity, class 3
E66.89	Other obesity not elsewhere classified
E66.9	Obesity, unspecified
Z68.25	Body mass index [BMi] 25.0-25.9, adult
Z68.26	Body mass index [BMi] 26.0-26.9, adult
Z68.27	Body mass index [BMi] 27.0-27.9, adult
Z68.28	Body mass index [BMi] 28.0-28.9, adult
Z68.29	Body mass index [BMi] 29.0-29.9, adult
Z68.30	Body mass index [BMi] 30.0-30.9, adult
Z68.31	Body mass index [BMi] 31.0-31.9, adult
Z68.32	Body mass index [BMi] 32.0-32.9, adult
Z68.33	Body mass index [BMi] 33.0-33.9, adult
Z68.34	Body mass index [BMi] 34.0-34.9, adult
Z68.35	Body mass index [BMi] 35.0-35.9, adult
Z68.36	Body mass index [BMi] 36.0-36.9, adult
Z68.37	Body mass index [BMi] 37.0-37.9, adult
Z68.38	Body mass index [BMi] 38.0-38.9, adult
Z68.39	Body mass index [BMi] 39.0-39.9, adult
Z68.41	Body mass index [BMi] 40.0-44.9, adult
Z68.42	Body mass index [BMi] 45.0-49.9, adult
Z68.43	Body mass index [BMi] 50.0-59.9, adult
Z68.44	Body mass index [BMi] 60.0-69.9, adult
Z68.45	Body mass index [BMi] 70 or greater, adult
Z68.53	Body mass index [BMi] pediatric, 85th percentile to less than 95th percentile for age
Z68.54	Body mass index [BMi] pediatric, 95th percentile for age to less than 120% of the 95th percentile for age
Z68.55	Body mass index [BMi] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age
Z68.56	Body mass index [BMi] pediatric, greater than or equal to 140% of the 95th percentile for age
Z91.89	Other specified personal risk factors, not elsewhere classified
Nonalcoholic steatohepatitis
K75.81	Nonalcoholic steatohepatitis (NASh)
Weight loss management for obese patient (bmi >= 30)
E66	Overweight and obesity
E66.0	Obesity due to excess calories
E66.01	Morbid (severe) obesity due to excess calories
E66.09	Other obesity due to excess calories
E66.1	Drug-induced obesity
E66.2	Morbid (severe) obesity with alveolar hypoventilation
E66.8	Other obesity
E66.81	Obesity class
E66.811	Obesity, class 1
E66.812	Obesity, class 2
E66.813	Obesity, class 3
E66.89	Other obesity not elsewhere classified
E66.9	Obesity, unspecified
Z68.3	Body mass index [BMi] 30-39, adult
Z68.30	Body mass index [BMi] 30.0-30.9, adult
Z68.31	Body mass index [BMi] 31.0-31.9, adult
Z68.32	Body mass index [BMi] 32.0-32.9, adult
Z68.33	Body mass index [BMi] 33.0-33.9, adult
Z68.34	Body mass index [BMi] 34.0-34.9, adult
Z68.35	Body mass index [BMi] 35.0-35.9, adult
Z68.36	Body mass index [BMi] 36.0-36.9, adult
Z68.37	Body mass index [BMi] 37.0-37.9, adult
Z68.38	Body mass index [BMi] 38.0-38.9, adult
Z68.39	Body mass index [BMi] 39.0-39.9, adult
Z68.4	Body mass index [BMi] 40 or greater, adult
Z68.41	Body mass index [BMi] 40.0-44.9, adult
Z68.42	Body mass index [BMi] 45.0-49.9, adult
Z68.43	Body mass index [BMi] 50.0-59.9, adult
Z68.44	Body mass index [BMi] 60.0-69.9, adult
Z68.45	Body mass index [BMi] 70 or greater, adult
Z68.55	Body mass index [BMi] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age
Z68.56	Body mass index [BMi] pediatric, greater than or equal to 140% of the 95th percentile for age
Wt loss mgmt for overweight pt w/ wt-related comorbidity
E66.3	Overweight
Z68.27	Body mass index [BMi] 27.0-27.9, adult
Z68.28	Body mass index [BMi] 28.0-28.9, adult
Z68.29	Body mass index [BMi] 29.0-29.9, adult