DR AUDET: Ms C is a 33-year-old African American
woman whose weight problems started in adolescence. Over the years, her weight
has increased, despite attempts to lose or stabilize it. She currently works
full-time and studies business administration. She previously studied culinary
arts. Ms C has commercial health insurance.
Ms C is a well-educated woman who talks about her weight without difficulty.
On initial assessment, her weight was 289.4 lb. Her height was 5'7'' and her
body mass index (BMI), 45.4 kg/m2. Her highest weight as an adult
was 296 lb and her lowest weight, 175 lb. Her obesity has contributed to additional
health problems, including irregular menses in the past. Ms C has been diagnosed
as having hypertension, which requires treatment with hydrochlorothiazide.
On 1 occasion, her random glucose was elevated. Her exercise capacity is diminished,
and she finds herself short of breath when walking and climbing stairs. In
addition, Ms C has a history of deep vein thrombosis following prolonged immobilization
during traveling. Ms C has a strong family history of obesity (her mother
and siblings), hypertension, type 2 diabetes mellitus, and coronary artery
disease. She does not smoke or abuse alcohol.
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