CASE STUDY: STRATEGIES FOR OVERWEIGHT INDIVIDUALS Mickey and Jim are brothers. T

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CASE STUDY: STRATEGIES FOR OVERWEIGHT INDIVIDUALS Mickey and Jim are brothers. Their parents, along with most other members of their family, are overweight and have hypertension. Mickey is the youngest of the family and at age 24 is overweight. He is 5’10” tall and weighs 188 lbs. Mickey is active, although not as active as he should be. He works at an advertising agency and is on the company softball team. They have been practicing every Saturday for the last three months. From 11am – 2pm Mickey is running bases, hitting balls, and playing the outfield. Afterwards, he and his friends go to the local pub for a few beers and a bite to eat. This “bite” is usually a burger and fries. Mickey’s brother, Jim is not active at all. He is 6’0” tall and weighs 338 pounds. Jim is a middle school history teacher. Most of his time is spent behind a desk or sitting at the table grading papers. When he needs a break, he usually goes to the fridge for a snack. Having grown up in the same household, Mickey and Jim have similar food preferences. Both love “old-fashioned” eating: bacon and eggs, ham and cheese, steak and potatoes. As kids, neither brother wanted to eat his vegetables, although they do eat some vegetables now. One habit they fully enjoy, and never grew out of is snacking on milk and cookies. To this day, they both have milk and cookies before bed. They were pudgy children, although they did not seem to eat much differently from the other kids in the neighborhood, they just gained more weight. Mickey loves food just as much as his brother, but he knows his weight is not healthy and that his brother’s is even worse. He asks Jim to go on a diet with him. At first, Jim seemed reluctant, but now he has turned Mickey’s weight loss challenge into a brotherly competition. Both are determined to lose at least 45 pounds in the next 10 weeks. Mickey decides that he needs to exercise more to lose weight. In addition to his Saturday softball practice, he plans to jog for 15 minutes twice a week. This does not produce results quickly enough, so Mickey tries using diet pills, but only “natural” ones. Mickey tries St. John’s Wort, but has tremendous difficulty sleeping at night. He also takes dieter’s tea, but he cannot deal with the nausea and cramping. Finally, he decides to go to his doctor and get prescription drugs. The doctor tells him that Sibutramin and Orlistat are the most common drugs on the market, but he feels Orlistat is the better choice for Mickey. Jim also goes to his doctor, but does so before attempting to change his activity level or trying natural diet products. He asks his physician if he would be a good candidate for bariatric surgery. Jim schedules an appoint for a consultation with the surgeon, but never sees it through. The brothers have a long talk and decide they should change their diets and eating habits to obtain healthier more long tem goals.

2. How much weight should Mickey aim to lose? How do their weight loss goals differ?

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2.

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