A 36-Year-Old Woman Comes to the Office Due to Difficulty

A 36-year-old woman comes to the office due to difficulty losing weight over the past several months.  The patient says, "I typically lose 1 or 2 pounds in the first week of dieting, but by the second week I lose control and start eating bags of cookies and potato chips."  These episodes are followed by a few days of fasting and exercising excessively.  The patient is upset about her weight and appearance but has no persistent sadness.  She enjoys her work and socializing with friends and family.  The patient has no medical conditions, but her menstrual cycle is irregular.  Weight is 67 kg (147.7 lb) and height is 160 cm (5 ft 3 in) .  BMI is 26.2 kg/m².  Blood pressure is 100/70 mm Hg and pulse is 86/min.  Physical examination shows dry skin but is otherwise unremarkable.  The patient has a full range of affect and no suicidal ideation.  Laboratory results are as follows: The diagnosis is discussed, and the patient asks if any medications are available for treatment.  Which of the following is the most appropriate recommendation?

A) Bupropion
B) Fluoxetine
C) Methylphenidate
D) No pharmacological therapy is effective
E) Olanzapine
F) Orlistat

Correct Answer:

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