CTCAE grading of weight gain:
Grade 1 (Mild): 5 to <10% increase from baseline
Grade 2 (Moderate): 10 to <20% increase from baseline
Grade 3 (Severe): ≥20% increase from baseline
Characterize the symptom (onset, pace)
Ask the patient:
Have you had issues with weight gain in the past? Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly? Have you recently started any new medications, OTCs, supplements, or marijuana?
Grade the symptom
Ask the patient:
How has your weight changed from baseline? Have you changed your diet recently? Your exercise routine?
Ask the patient:
Are you having any difficulty swallowing? Do you feel like your heart is going real slow? Are you always cold? Do you feel like yourself mentally (i.e., are you a bit depressed)? Is your hair dry or falling out? Your skin dry? Are you puffy?
Do you have new or worsening shortness of breath, increased fatigue, chest pain, abdominal (belly) pain, or does your heart feel like it is racing or skipping a beat?
Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?
Patients with new onset moderate or worse (or worsening) weight gain should be seen.
Patients with any of the red-flag symptoms should be seen immediately.
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What do you suspect is the cause of the weight gain?