Mrs. Lin, a 40-year-old working mother, has been following several popular television shows discussing health and lifestyle. She has struggled with obesity for 8-10 years, trying several fad diets but adhering to each for no more than 2-4 months. She has found dieticians to be unhelpful for her busy life, which includes 3 children under 10 years of age. Her exercise consists mainly of daily walking for 1-2 miles.
Her body mass index (BMI) is 31 kg/m2 (normal, 18.5-24.9 kg/m2; obese ≥ 30 kg/m2); this is an improvement from 3 years ago, when it was 35 kg/m2. A recent medical work-up showed normal thyroid function, a low-density lipoprotein cholesterol level of 150 mg/dL (optimal < 100 mg/dL; borderline high, 130-159 mg/dL), a high-density lipoprotein cholesterol level of 40 mg/dL (low < 50 mg/dL for women), and a normal triglyceride level. Mrs. Lin asks whether you can prescribe human chorionic gonadotropin (hCG) injections for weight loss or if she should obtain it over the Internet.