A 29-year-old woman presents to an obesity medicine specialist for weight management. Her body mass index (BMI) is 32 kg/m2 (198 lbs, 5′6″), and she suffers from depression, irritable bowel syndrome with diarrhea (IBS-D), and migraines. Her medications are oral contraceptive pills, sertraline 150 mg daily, and sumatriptan 50 mg as needed for migraines, which occur two to four times per month. She has lost weight successfully several times in the past through diet and exercise; however, she always regains the weight. A few months ago, she started a low carbohydrate diet and an exercise routine. After losing 8 pounds (206 ➔ 198 lbs), she quickly reached a weight plateau despite ongoing diet and exercise. She is very frustrated and does not understand why she is unable to lose weight and maintain weight loss. She denies history of anxiety or nephrolithiasis. Her exam is within normal limits, and her laboratory data reveal no abnormalities besides low high-density lipoprotein (HDL), high low-density lipoprotein (LDL), and elevated triglycerides.
KeywordAnti-obesity medication Body mass index Hyperlipidemia Lifestyle modification Pharmacotherapy
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