Skill Checkup: A 43-Year-Old Woman Gains Weight After the Initial Weight Loss Achieved With Diet and Exercise

Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS; Evelyn S. Marienberg, MD


November 14, 2023

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

A 43-year-old woman in the United States returns to her physician complaining of weight gain after the initial weight loss she achieved with lifestyle modification in the form of diet and exercise.

A year ago, at the urging of her physician, the patient (who then had a body mass index [BMI] of 41.3) enrolled in and completed 12 weeks of a group-based weight loss program. After those 3 months, she attended a follow-up visit with her physician, where a loss of 8% of her total body weight was recorded. Encouraged by these results, the patient and her physician agreed that it would be ideal if she could keep up with the program and maintain the 80 minutes of walking she had been able to incorporate into her week.

However, at the current visit, the patient returns for her annual exam feeling incredibly discouraged. Her BMI at this visit was 40.9, which reflects weight gain since the last follow-up visit. During their discussion, the patient explained that she could continue with the group program and exercise regimen for ≥2 months after the follow-up visit and was feeling good about her accomplishments, but then she switched jobs and found attending her regular group meetings challenging. Without this frequent and continuous support, she struggled with the constraints of managing her consistency with her lifestyle modifications. Regardless, she told her physician that she was proud that she could keep up with her walking routine.


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