A Hispanic female, age 27, has come to the clinic with a complaint of rapid weight loss during the past 6 months despite having a voracious appetite and also that, with the onset of hot weather, she is feeling extreme discomfort. Furthermore, she feels extremely anxious without reporting any severe stressor in her personal life. Her physical exam reveals tachycardia (pulse rate > 100 bpm), fine moist skin, a fine tremor, and a symmetrically enlarged thyroid. Further blood work demonstrates elevated free triiodothyronine (> 10 pmol/l) with TSH at less than 0.2 mlU/l.

Critical Thinking Questions (To Answer)
1. What are the main presenting issues? Include why they may have arisen.
2. Identify at least one website that you used to learn more about the issues and potential solutions; briefly explain what was found at the website(s).
3. What is (are) the potential disease or disorder? Include (a) a justification for your decision, (b) the causal agent, and (c) the mode of transmission.
4. What is the recommended treatment for the most likely disease or disorder you identified?
5. What is the prognosis for the disease or disorder (a) without treatment and (b) with treatment?
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The most important component of an effective weight-management program must be the prevention of unwanted weight gain from excess body fat. The military is in a unique position to address prevention from the first day of an individual’s military career. Because the military population is selected from a pool of individuals who meet specific criteria for body mass index (BMI) and percent body fat, the primary goal should be to foster an environment that promotes maintenance of a healthy body weight and body composition throughout an individual’s military career.  there is significant evidence that losing excess body fat is difficult for most individuals and the risk of regaining lost weight is high. From the first day of initial entry training, an understanding of the fundamental causes of excess weight gain must be communicated to each individual, along with a strategy for maintaining a healthy body weight as a way of life.

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