A 27-year-old woman developed swelling and a 68.2-kg weight gain over the previous year. She had been taking lithium for a personality disorder and obsessive-compulsive disorder. She reported no steroid use. She had secondary amenorrhea for 3 years. She had a strong family history of obesity.
On physical examination , she was obese with a BMI of 78 kg/m2 (height, 152.4 cm; weight, 181.8 kg) and 4+ lower extremity tense edema. She had cushingoid features, but her extremities were not thin and there was no muscle wasting. Postoperatively , her weight decreased from 181.8 kg to 118.2 kg in the first postoperative year (35% decrease in BMI from 78 to 51 kg/m2; 49% loss of excess body weight and 35% loss of total body weight). She had a laparoscopic cholecystectomy after the first postoperative year. Currently , she supplements her diet with vitamin D and a multivitamin and maintains her…
