1. (1) Every physician who prescribes, orders, dispenses or administers a controlled substance to a patient for the purpose of weight reduction or treatment of obesity should maintain medical records in compliance with the provisions of this Chapter and Medical Licensure Commission Rule 545-X-4-.09, Minimum Standards for Medical Records.
2. (2) The treatment of obesity should be based on evidence-based medicine.¹ The Board considers the promotion and use for weight reduction of controlled and non-controlled substances which have not been scientifically validated to be of questionable benefit (e.g., HCG, etc.). The promotion and use of these substances is under scrutiny by the Board for possible sanctions for non-1egitimate medical use violations. Adequate medical documentation should be kept so that progress as well as the success or failure of any modality is easily ascertained.

3. (3) At a minimum, every thirty-five (35) days when a controlled substance is being provided to a patient for the purpose of weight reduction or treatment of obesity, the physician or PA or CRNP should record in the patient record, information demonstrating the patient’s continuing efforts to lose weight, the patient’s dedication to the treatment program and response to treatment, and the presence or absence of contraindications, adverse effects and indicators of possible substance abuse that would necessitate cessation of treatment utilizing controlled substances.

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   ¹ An example of evidence-based medicine would include the Bariatric Practice Guidelines as established by the Obesity Medicine Associate (formerly the American Society of Bariatric Physicians) and which can be found on the website www.obesitymedicine.org.

Author: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, §34-24-53.

History: New Rule: Filed December 16, 2011; effective January 20, 2012. Amended: Filed May 17, 2012; effective June 21, 2012. Amended: Filed April 15, 2016; effective May 30, 2016.