This clinic week , I saw a 65 year old M with morbid obesity with Uncontrolled Diabetes presented to the clinic with uncontrolled blood sugars . On questing further he admitted to not being adherent to diabetic diet although he takes his medications regularly . His BMI was 55 kg / m2 and had gained 20 lbs since over 2 months.
Despite taking complete medical history the reason for non – adherence was not clear . when asked him question about his living situation , he told that currently he is living in a temporary place but after few months he has to evacuate the place. He was recently denied disability claim , he is not working currently , does not have a fixed stable income . He always has urge to eat , and cannot do anything at home other than eating when in distress. On counselling / encouraging him to start working and search for job , he did not seem interested .
In such scenario it is very challenging as a clinician to advise . Possible underlying depression and mental issues and medical issues may be solved by medicines but if the pt is not willing to do anything then it becomes very difficult .
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