Case Study

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Mrs. X, a sedentary 45 year old, is 64” tall, weighs 165.5lbs and has a waist circumference of 37”. At a recent routine checkup with her physician her blood pressure was measured at 135/85mmHg and her blood tests were normal. Regardless, her doctor has suggested she make some changes to her lifestyle to try and reverse the deterioration in her health he has observed since her last visit.
1. Outline her risk factors that the doctor was concerned about. Is anyone risk factor more prominent or problematic than the others?
A risk factor is anything that increases a person’s chances of developing a disease. In this case with Mrs. X, her risk factors are her weight, waist circumference and blood pressure. Her weight and height puts her at a body mass index (BMI) at 28.4 kg/m2, which is associated with an increased risk for type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease (CVD). Also women are at increased relative risk if they have a waist circumference greater than 35 inches, in Mrs. X’s case she is 2 inches over the standard. As well as her blood pressure reading of 135/85mmHG, puts her on the verge of being hypertensive. Although all the risk factors are important to note, I believe that the Mrs. X’s BMI is the most problematic risk factor.

2. Outline a plan of lifestyle modification to target her risk factors.
Mrs. X’s Lifestyle Modification Plan
1. Brief reinforcement/educate on weight management
a. Does Mrs. X want to lose weight?
i. The decision to lose weight must be made jointly between the clinician and patient.
b. Those with BMI between 25 and 29.9 kg/m2 and who have one or no risk factor should work on maintaining their current weight.
2. Dietary Therapy
a. Mrs. X is in the “overweight” bracket
i. A deficit of 300 to 500 kcal/day may be more appropriate, providing weight loss of about 0.5 pounds per week.
3. Physical activity
a. Moderate levels of physical activity for 30 to 45 minutes, 3 to 5 days per week.
i.

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