Ace the Case: A 15-Year-Old Girl With Morbid Obesity

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Question 1
The patient is referred to a weight loss clinic. She is seeing a nurse practitioner, registered dietitian, and counselor weekly. After a few months, her weight has not changed. What is the next best step?
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Correct answer: C

Rationale: This patient is a candidate for bariatric surgery.15 She meets criteria based on her BMI alone, as well as her comorbid diagnosis of high blood pressure.15 Although dietary modifications or exercise may be considered, studies have shown that bariatric surgery is more effective at reducing weight in adolescents than diet and exercise alone.15 Because orlistat has shown mixed results, bariatric surgery is still the best answer.5,12

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