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Ideally, that physician should have expertise in obesity medicine (family practice or endocrinology), not just psychiatry Pennsylvania: Require Collaborative Agreement that specifically includes weight-loss protocols California: Operate under Standardized Procedures with MD supervision unless you qualify for independent practice under AB 890 (phases in through 2026) States with Full Practice Authority (FPA): Illinois: APRNs with 4,000+ hours experience can practice independently, but youre still expected to practice within your competence treating obesity as a psych NP might raise questions New York: After 3,600 hours, NPs can practice without formal collaborative agreements but must maintain collaborative relationships and refer appropriately The smart approach for PMHNPs: If treating weight gain related to psychiatric medications: Youre on solid ground this is clearly within psych scope (e.g., prescribing metformin or a GLP-1 to offset olanzapine-induced weight gain) If running a pure weight-loss practice: Get explicit physician collaboration (preferably with an obesity specialist) or pursue additional certification (e.g., WHNP or FNP credentials, or obesity medicine training) Document the psychiatric connection: If treating patients with binge eating disorder, depression affecting motivation, or medication-induced weight gain, you have a stronger scope argument The Economics: Why Weight Loss Makes Sense for Psychiatric Practices Lets talk business

Signs and symptoms [edit] The only sign of vitiligo is the presence of pale, patchy areas of depigmented skin, which tend to occur on the extremities

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