ABSTRACT
Patient profile Sam is a 67-year-old man with a history of an uncomplicated myocardial infarction (MI) at age 55 years and an ischemic stroke 3 months ago that has left him with slight left upper arm weakness. Aside from the stroke Sam believes his recent general health has been good. However, since his MI he has become increasingly sedentary and gained appreciable weight. He describes multiple attempts to lose weight, employing different kinds of diets, without much success. For the past 3 years Sam has been treated with a statin because a doctor, a specialist, told him that his cholesterol was too high.