Obesity: AZ is a 30-year-old woman who comes to your office seeking help for her weight. She currently weighs 250 pounds and is 5’6” tall. She admits that her weight is related to poor eating habits. Her diet consists of fast food and highly processed foods (chips, crackers, donuts, candy, etc.). She finds herself eating when she is stressed, eating when bored and eating just because she cannot stop. She describes herself as “being obsessed with food, unable to control her urge to eat when the urge strikes.” She is single and has no children. Her father (age 69) is alive and well with HTN, and hyperlipidemia. Her mother is also alive (age 67) and well with type 2 diabetes, HTN, hyperlipidemia and a history of depression. AZ has a sedentary job at an insurance company. Her company recently offered an incentive for employees who meet certain health goals. She is also aware that her current metabolic status is putting her at risk of diabetes, HTN and hyperlipidemia, all of which run in her family. AZ has tried to lose weight through various dieting techniques (Atkins diet, Weight Watchers, increasing exercise, cutting back on calories, etc.). Her attempts have always been thwarted by her inability to refrain from “feeling the urge to eat all the time.” She is willing to try anything necessary to lose weight and assume a healthier life style. Other than her weight, she is in good health; her labs are within normal limits; physical exam is normal.
- What therapeutic options exist for this patient? Identify three different options and explain how each works to help the patient lose weight.
- Which option do you think would be most beneficial for the patient? Explain why.
- Provide dosing instructions, monitoring parameters, and patient education necessary for the safe use of the selected medication.
- What other non-pharmacological recommendations would you have for this patient to help her succeed in her weight loss efforts?