Course Case Studies
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Mr. G is a White man, 54 years of age, with a past medical history of hypertension. At his yearly physical, he reports that he is doing well overall, with no complaints other than some dyspnea on exertion, which has been long-standing. Current medications include a thiazide diuretic and aspirin. He works as an accountant and does not get much physical activity during the day.
On exam, Mr. G is 5'11" and 210 lbs. His BMI is 29. This classifies him as overweight.
(BMI may be used to help define overweight and obesity, which is weight-adjusted for height. It is calculated by [weight in kg] divided by [height in meters]2 OR [weight in pounds] divided by [height in inches]2 x 703. A BMI of 25.0 or greater is defined as overweight, and a BMI of 30.0 or more is considered obese.)
Based on his waist circumference, IFG, decreased HDL, and increased triglycerides, Mr. G. meets the definition of metabolic syndrome. Aggressive treatment of the risk factors is warranted.
Currently, Mr. G snacks on sugary treats throughout the day, as he does not take time to eat breakfast and frequently goes without lunch. By the time he eats dinner, relatively late in the evening, he is famished and tends to overeat. Mr. G has very little nutritional information about the food he eats. Either the physician can provide some basic dietary information, or the patient can be referred to a dietitian. The goals of dietary counseling for Mr. G would be:
Mr. G first should understand roughly how many calories he is consuming per day. His goal should be to consume no more than 2,000 calories per day. He may wish to keep a food log for two to three days to get a better idea of exactly how much he is eating. This log could be reviewed at the next visit.
He should divide the recommended calories over at least three meals. Eating breakfast should be emphasized, as there is data that supports the premise that eating breakfast helps to maintain one's weight rather than cause weight gain.
In addition, he should minimize snacking on food high in sugar, sodium, and added fat and substitute these for nutrient-dense food/beverage choices. Because he consumes a fair amount of soda, simply eliminating one can of soda per day could lead to a 5- to 10-pound weight loss over the course of a year. The emphasis should be on gradual lifestyle changes that are sustainable and acceptable to Mr. G.
- Back to Course Home
- Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.