A 38-year-old woman with type 2 diabetes, hy-perllpidemia, well-controlled hypertension, diarrhea-predominant irritable bowel syndrome, and- sleep apnea presents to discuss medical treatments for obesity. She has been overweight since childhood and has dieted since her teenage years using fad or commercial weight-loss programs. Maximal weight loss achieved was 9% of her body weight at 6 months on 3 occasions, but she was unable to keep the weight off beyond 1 year. She works as a travel agent out of her home and is married with 2 teenage children. Her medications include atorvastatin, hydrochlorothiazide, diltiazem, and oral hypoglycemic agents, and she uses continuous positive airway pressure inconsistently.
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