Question

Application 10.1 John is a 34-year-old accountant with a small firm that specializes in tax law. He works long days, typically 6 days a week, and travels 5 or 6 days every month. He likes to cook and to eat, enjoying the social aspects of a meal. But, as a busy single man, John finds himself frequently dining out and relying on convenience food. He is 6 feet tall and weighs 250 lb. Both John and his doctor want him to lose weight to get his blood glucose under better control and to avoid going on blood pressure medication. “If you don’t start exercising,” his doctor recently observed, “you will find yourself taking medication for hypertension and type 2 diabetes.” For a few weeks John complied with his doctor’s recommendation. He used the fitness facilities when staying in hotels and tried out a few health clubs in his neighborhood, even though exercise made his knees hurt. But as tax season approached, he got even busier at work, and the exercise diminished. John asked his doctor about taking Xenical, which he heard about from a client. His doctor discussed the medication with him and agreed to write him a prescription. 1. Is John an appropriate candidate to take a weight-loss drug? 2. What information should John’s physician give him about Xenical? 3. What kind of weight loss might John expect from taking this medication? How could he improve the chance of losing more weight?

Answer 1

Is John an appropriate candidate to take a weight-loss drug?

• If a person is overweight, and dieting and exercise haven't worked for him, then he may talk to his doctor about a weight management program that involves medication (Xenical). But also to remember, to follow a healthy lifestyle that involves regular exercise and eating right.
• To determine if John is overweight, we can calculate the body mass index (BMI) using the height and weight information. A BMI of 18.5 to 24.9 is considered a healthy weight. A BMI of 25 to 29.9 is considered overweight. And the BMI of john according to his height (6 ft) and weighgt (250lb) is 33.90 much above the cut limit of overweight
• The drug will also offer coverage for risks that come with obesity, including heart disease, diabetes, high blood pressure, and a shorter life, which already john is prone to (Diabetes And hypertension as discussed by his doctor).

What information should John’s physician give him about Xenical?

• Take this medication as directed by your doctor, by mouth with liquid sometime during each meal that contains fat or within 1 hour after the meal, usually 3 times daily.
• If you miss a meal or your meal contains no fat, skip that dose of the medication.
• To decrease the chance of unpleasant side effects, it is very important that no more than 30% of the calories in your diet come from fat.
• Your daily intake of fat, protein, and carbohydrates should be evenly spread over 3 main meals.
• Do not increase your dose or use this drug more often or for longer than prescribed.
• Your condition will not improve any faster, and your risk of side effects will increase.
• Because this drug can interfere with the absorption of certain vitamins (fat-soluble vitaminsincluding A, D, E, K), a daily multivitamin supplement containing these nutrients is recommended.
• Take the multivitamin at least 2 hours before or 2 hours after taking xenical (such as at bedtime).
• If you take cyclosporine, take it at least 3 hours before or after xenical to make sure the full dose of cyclosporine is absorbed into your bloodstream. If you take levothyroxine, take it at least 4 hours before or after xenical.
• You should see some weight loss within 2 weeks after you start xenical.
• Inform back doctor if the condition does not improve or if it worsens.
• Stop use if severe or continuous abdominal pain occurs. This may be a sign of a serious medical condition.

What kind of weight loss might John expect from taking this medication?

researches shows that a regular use of xenical with balanced diet and exercise will leads to loose 5-10 pounds of weigh over 6 months periods.

How could he improve the chance of losing more weight?

Exercise:

• Let’s start with exercise. In order to shed the pounds, you must exercise sufficiently, 30 minutes a day to start, at least 5 days a week.
• The big secret to weight loss is not so much a secret at all. You must burn off more calories through physical activity than you consume.
• It really is that simple! Exercising sufficiently results in your body utilising its fat stores as a source of energy. This results in weight loss.
• Understanding the mechanism of weight loss is not so much the difficult part.
• So, in order to lose the pounds, you must incorporate more exercise into your daily routine.
• This could be taking the stairs rather than the lift or enduring a hardcore cardio session at the gym. Just get your body moving.

Diet:

• Diet often proves to be the defeating factor of weight loss as it accounts for a massive 90% of the battle, in comparison to a measly 10% as a result of exercise. For this reason, it’s very important you understand what you should/should not be eating.
• The ability to sustain a healthy diet can be immensely hard and even psychologically challenging!
• Step one is to identify your biggest unhealthy food weaknesses and either avoid them at all costs or reduce them significantly replacing them with healthy alternatives.
• It is ok to leave some higher calorie foods for ‘cheat days’, however, this must be done in moderation ensuring cheat days do no turn into ‘cheat weeks’!
• the first step in dieting is altering your meal choices.
  • Eat regularly with 3 main balanced meals (eating slowly and chewing food properly will make you feel fuller).
  • Keep healthy snacks in arms reach to avoid naughty snacking spurs between meals (e.g. fruits, carrot sticks etc.)
  • Decrease portion sizes.
  • Eat plenty of fruits and vegetables.
  • Drink plenty of water- often the feeling of thirst is confused with feelings of hunger. Keep yourself hydrated drinking around 2 litres of water a day to prevent unnecessary overeating.
  • Be picky with your food choices and always read the labels.
  • Decrease your fat consumption!
  • Be prepared for fluctuations in weight, nobody is perfect!
• Be consistent and stay motivated!

For every 5 pounds john lose from diet alone, Xenical can help john lose 2-3 pounds more.