Problem:
Mary Williams is a 62-year-old female who is 5′4″ and weighs 223 lbs. Mary has stage 4 CKD, poorly controlled type 2 diabetes, and class II obesity. She was "chunky" as a child and adolescent, with a lifetime habit of having consumed a relatively high-fat, high-calorie diet. As she recalls, her entire family was overweight, and she believed she had little control over her obesity.