A Man with a BMI of 38 and a Waist

A man with a BMI of 38 and a waist size of 48 inches is seen in the clinic for an annual well check-up.The primary care NP orders laboratory tests and notes a fasting plasma glucose of 110 mg/dL,triglyceride level of 220 mg/dL,and high-density lipoprotein level of 40 mg/dL.The man's blood pressure is 160/110 mm Hg.The man has a history of cardiovascular disease and tells the NP he has tried to lose weight numerous times.The NP should consider:

A) orlistat (Xenical) .
B) phentermine (Adipex-P) .
C) an oral antidiabetic agent.
D) a strict low-fat, low-sodium diet.