ABSTRACT
Tom, a 48-year-old African American pharmaceutical sales representative, discovers during his biannual physical that he has hypertension (sustained periods of high blood pressure). Tom is particularly troubled by the news because his father, who also had high blood pressure, died of a massive stroke about ten years earlier. Tom knows that he should be more careful about his health. He used to pride himself on being physically fit. In his 20s, Tom played basketball several evenings a week with friends and participated in a men’s league at the local YMCA. However, as the years passed, attendance at pickup games gradually dropped off and Tom became aware that the other players in the men’s league were getting younger and younger (compared to him). Tom was discouraged by how sore he felt one, two, or even three days after playing ball. He felt increasing pressure from his wife to spend more time with their children. Eventually, Tom quit playing basketball altogether. Tom’s job has him on the road a great deal of the time. He often eats in fastfood restaurants and snacks on chips in his hotel room at night. Over the years Tom’s weight has steadily increased. He is about 40 pounds heavier than when he graduated from college.
