MKSAP: 48-year-old woman with gradual weight gain

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old woman is evaluated during a routine examination. She is concerned about her gradual weight gain over the years and requests counseling on how she can most effectively lose weight. Over 8 years, she has gained approximately 18 kg (40 lb). With several commercial diets, she has lost weight but always gains it back. She has a sedentary job, and often skips breakfast or eats dinner on the run. She states she cannot fit exercise into her busy day. She takes no medications and has no allergies. On physical examination, temperature is normal, blood pressure is 132/70 mm Hg, pulse rate is 80/min, and respiration rate is 12/min. BMI is 32. There is no thyromegaly. The abdomen is obese, soft, nontender, and without striae. Fasting plasma glucose level is 106 mg/dL (5.9 mmol/L) and thyroid function test results are normal. Which of the following is the most appropriate next step to help this patient achieve long-term weight reduction? A. Exercise 15-30 minutes 5 days/week B. Laparoscopic adjustable band surgery C. Orlistat D. Reduce current caloric intake by 500-1000 kcal/d Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Obesity Source Type: blogs