Food Addiction Cases

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Jane is a new patient in the Weight Loss clinic. She presents as a slightly chubby young woman of 25 years of age, ht: 5 ft.wt: 150 lbs. She describes a series of diets where she loses 5 to 10 lbs, then becomes frustrated when she plateaus for several weeks, and breaks the diet, rapidly regaining her lost weight. Her lifestyle is mostly sedentary during the week; she plays tennis on the weekend occasionally or goes dancing at the local singles bar. She wants medication that will make her lose weight and keep her from being hungry. What would you do?

  1. Tell Jane that in order to help her, first she must provide more information. Give her a food diary and ask her to put down everything that she eats and drinks (what and how much). She also is to write a sentence about her mood when she eats and if anything occurred prior to eating. Dialogue about triggers. Ask her to return in one week and be prepared to also meet with a nutritionist at that visit.
  1. Write Jane a script for an amphetamine, warning her that she must not take it more than directed.
  1. Dialogue about bariatric surgery. Explain that her weight is a risk factor for Type 2 diabetes. Send her to the lab for a blood draw (A1c), and give her a pile of bariatric surgery leaflets and pamphlets. Ask her to return in 2 weeks.
  1. Explain that losing weight is just reducing calories you eat and increasing calories you burn by exercising. Give her a diet and an exercise program and tell her to return in one month.