Your patient today is Mrs. Goldman. She is a sedentary 45 year old. She is 66” tall, weighs 255 lbs and has a waist circumference of 37”. At a recent routine check-up with her physician her blood pressure was measured at 135/85mmHg, her HDL was 40, her total cholesterol was 225 and her TG were 199. She has 2 sisters that are diabetic, and she was told at her last visit that she is “prediabetic”. Mrs. Goldman is a stay at home mother of 3 boys aged 12, 14 and 16. While her oldest child is fairly active and plays football, the other two children are considered obese and are in the top quintile for weight for their age. Mrs. Goldman has come to you with the following questions:
1. I saw on “The Doctors” television show that there was something called “lousy” cholesterol. What is that and is mine at a good level?
Many people don’t realize that there are two cholesterol levels. One being “good” and one being “bad”, also known as “lousy”. Your lousy cholesterol is slightly more elevated than it should be. Which means you should get under control to avoid risk of heart problems. LDL, which is bad cholesterol, clogs arteries and could cause heart disease.
2. I have never been this big, but I seem to have put on a few pounds in the last few years. What effect can my weight have on my health?
It increases the risk of several diseases such as cardiovascular diseases and diabetes mellitus. There are also other conditions that’s likelihood is increased which include hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, and respiratory problems. Not to forget cancers of the endometrium, breast, prostate, and colon.
3. Is gastric bypass surgery a good option for me? (Be sure to include why or why not)
As your BMI shows to be 41.15 kg/m2, which would categorize you under clinically severe obesity which