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Jakub, 56

Jakub is a 56-year-old male who works as a transport manager.

He is visiting you to review his health screen results.

Patient history

  • Recently attended for vaccinations
  • Was encouraged by primary care physician to undergo a health screen
  • Jakub has returned to the clinic to talk through the results

Current clinical measurements

  • BMI 34 kg/m2 (8 months prior: BMI 32 kg/m2)
  • HbA1c 5.8% (40 mmol/mol)
  • BP 132/88 mmHg
  • Total cholesterol 3.9 mmol/L (151 mg/dL)
  • Non-smoker and moderate alcohol consumption
  • LDL cholesterol 2.0 mmol/L (77 mg/dL)
  • ALT 21 U/L and AST 14 U/L
  • FIB-4 score 1.0 (learn more )
  • eGFR 98 mL/min/1.73 m2

ALT: alanine aminotransferase; AST: aspartate aminotransferase; BMI: body mass index; BP: blood pressure; eGFR: estimated glomerular filtration rate; FIB-4: Fibrosis-4 index; LDL: low-density lipoprotein; UTI: urinary tract infection

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Clinical data 

This is a fictional case study. The model is not a real patient and the situation shown does not reflect the model's experience.

References
  1. Vieira Barbosa J, Milligan S et al. Fibrosis-4 index as an independent predictor of mortality and liver-related outcomes in NAFLD. Hepatol Commun 2022;6(4):765-779
  2. Loomba R, Adams L A. The 20% rule of NASH progression: the natural history of advanced fibrosis and cirrhosis caused by NASH. Hepatology 2019;70(6):1885-1888
  3. Sterling R K, Lissen E et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006;43(6):1317-1325
  4. Yumuk V, Tsigos C et al. European guidelines for obesity management in adults. Obes Facts 2015;8(6):402-424
  5. Wharton S, Lau D C W et al. Obesity in adults: a clinical practice guideline. CMAJ 2020;192:E875-E891
  6. McHale C T, Laidlaw A H, Cecil J E. Primary care patient and practitioner views of weight and weight-related discussion: a mixed-methods study. BMJ Open 2020;10(3):e034023
  7. Dewhurst A, Peters S et al. Physicians’ views and experiences of discussing weight management within routine clinical consultations: a thematic synthesis. Patient Educ Couns 2017;100(5):897-908
  8. Caterson I D, Alfadda A A et al. Gaps to bridge: misalignment between perception, reality and actions in obesity. Diabetes Obes Metab 2019;21(8):1914-1924 (+ suppl)
  9. Albury C, Strain W D et al. The importance of language in engagement between health-care professionals and people living with obesity: a joint consensus statement. Lancet Diabetes Endocrinol 2020;8(5):447-455
  10. Canadian Adult Obesity Clinical Practice guidelines. Reducing weight bias in obesity management, practice and policy. Available at: obesitycanada.ca. Accessed August 2023
  11. Obesity UK. Language matters: obesity. Available at: cdn.easo.org. Accessed August 2023
  12. Auckburally S, Davies E, Logue J. The use of effective language and communication in the management of obesity: the challenge for healthcare professionals. Curr Obes Rep 2021;10(3):274-281
  13. Phelan S M, Burgess D J et al. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev 2015;16(4):319-326
  14. Talumaa B, Brown A et al. Effective strategies in ending weight stigma in healthcare. Obes Rev 2022;23(10):e13494
  15. Guidelines in practice. Top tips: talking about weight. Available at: guidelinesinpractice.co.uk. Accessed August 2023
  16. Breen C, O'Connell J et al. Obesity in adults: a 2022 adapted clinical practice guideline for Ireland. Obes Fact 2022;15(6):736-752
  17. Sturgiss E, van Weel C. The 5 As framework for obesity management: do we need a more intricate model? Can Fam Physician 2017;63(7):506-508
  18. Salas R X, Forhan M et al. Addressing internalized weight bias and changing damaged social identities for people living with obesity. Front Psychol 2019;10:1409