AKT2-080

Mrs Strangler is a 55 year old female who is a regular patient. She had a myocardial infarction six months ago and since then has been very motivated to lose weight as her BMI is 35. Apart from Ischaemic Heart Disease, Mrs Strangler also has diet-controlled Type 2 Diabetes Mellitus and a frozen shoulder (right-sided). At your last consultation (12 weeks ago) you discussed various weight loss strategies and together decided on referral for an exercise programme and Orlistat. Mrs Strangler has come today for review, she has experienced mild loose bowel motions but has no other significant side-effects. She has started an exercise programme that is going well. Weight today is 97 kg (100kg, 12 weeks a go).

What is the next most appropriate action?

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