* 40-year-old woman, 5 feet 1 inch tall and weighing 188 pounds came for consultation to * physician complaining of frequent episodes of dizziness and numbness in her legs. She was too worried for her weight. Her waist measured 41 inches and hip measured 39 inches. Her only child who was 15 year old, her sister and both of the parents were over weight. The patient recalled that she had been obese throughout her childhood and adolescence. Over the past 6 years she had been on seven different diets for periods of two weeks to three months, losing from 5 to 25 pounds. On discontinuation of each diet, she regained weight returning to 185 to 190
pounds.
During routine physical examination the patient was observed to be hypertensive
(blood pressure of 200/120 mm Hg) but no abnormality was detected upon examination of Chest, CNS and Abdomen. The patient was asked to return to the clinic * week later in the fasting state, during which time * blood specimen was obtained. Blood Biochemistry revealed fasting hyperglycemia, hyperinsulinemia, Dyslipidemia, and glucose intolerance.
What is the probable diagnosis?
What other investigations should be carried out to confirm the diagnosis?
Calculate the BMI for this woman and comment on the grade of obesity
