A 54-Year-Old Woman Comes in for Her Annual Preventative Checkup

A 54-year-old woman comes in for her annual preventative checkup. She has no particular concerns. The blood pressure is 144/95 mm Hg, and the pulse rate is 86 beats per minute. 50 kg/m² is the BMI. The examination reveals extreme obesity but else is ordinary. The fasting glucose level is 128 mg/dL. When asked about her weight, the patient responds, "My family simply enjoys eating. My mother, father, and children are all overweight. It's pointless to try to reduce weight right now." Which of the following responses to this patient's remark is most appropriate?

A) "Bariatric surgery might be a good option for you to consider."
B) "Even with your family history, simple changes in your diet can lower your blood pressure."
C) "Tell me how you think your weight might relate to your blood pressure and glucose."
D) "You can still eat whatever you want as long as you don't eat so much of it."
E) "You don't have to lose all the weight at once.  A little at a time will eventually make a difference."