Consider These Cases

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.

Mr. Ford, 28 years old, is overweight, with a BMI of 29 kg/m2. He is averse to medications and fad diets. He goes to the gym 3 times a week for a 1-hour workout and takes long bike rides on weekends. He would like to lose 10-20 pounds to improve his body image and his perceived success at work and socially. He would like to take natural products that promote weight loss, as this would be easy for him to do. He asks you whether he should try green coffee beans, green tea, raspberry ketone, or açaí berry, all of which he read about on the Internet. Mr. Ford admits that some of his friends have tried the products with no significant results after several months, but he feels that they are worth a try because they are “natural and not harmful to health.”

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