AccessMedicine's Case of the Week: Nutrition and Herbal Medicine

From: Graber and Wilbur’s Family Medicine Examination and Board Review, 4th Edition

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A 34-year-old female presents to your office with concerns about weight gain. She has gained over 100 lb since she graduated from high school. She tearfully reveals that the weight gain has come despite "not eating much." She walks for exercise, but is unable to quantify her walking.

She denies chronic illnesses. Her only surgery was a tubal ligation after her last child. She smokes 10 cigarettes per day and is unwilling to quit due to fears of further weight gain. She drinks alcohol once or twice per week, never consuming more than three beers. The review of systems is positive for a dry cough, bilateral knee pain, and fatigue.

On physical examination, you find an afebrile female with an elevated blood pressure (142/94 mm Hg). She is 5 ft 3 in tall and weighs 231 lb. Her body mass index (BMI) is 41 kg/m2. You find trace pitting edema at the ankles bilaterally. There is increased pigmentation in the folds of the neck and the knuckles. The remainder of the examination is unremarkable.

The patient realizes that she is overweight and asks, "How bad am I?"

Question 1 of 9

Regarding definition and classification of obesity, which of the following is true?

A - Obesity is defined as BMI ≥25 kg/m2

B - Severe obesity is defined as BMI >30 kg/m2

C - Underweight is defined as BMI <20 kg/m2

D - Obesity is defined as BMI ≥30 kg/m2

E - Malnourished supermodel status is defined as BMI <30 kg/m2

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Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education