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Referral to cardiology is appropriate for patients with: Uncontrolled hypertension (160/100 mmHg) despite multiple medications Recent cardiovascular events (within 6 months) Symptomatic heart failure Complex arrhythmias Significant valvular disease Shared decision-making should incorporate discussion of expected weight loss magnitude, potential cardiovascular benefits including blood pressure reduction, common adverse effects (nausea, diarrhea, constipation), cost considerations, and the need for long-term treatment to maintain benefits

If you deal with bloating or gas, certain fiber supplements may make symptoms worse at first since some fibers ferment in the gut and increase gas production

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Renal monitoring is crucial, especially if you experience dehydration from side effects like vomiting or diarrhea

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