Is it right for me?

Jo, 35yo single mum

2 kids aged 6yo and 2yo

Works part time in an admin role for a building insurance company, some financial support from ex-husband. Limited social circle, family lives interstate as she moved with her husband to Perth while they were married 8 years ago for his work as a FIFO chemical engineer.

Experiences anxiety/depression since divorce, sleep difficulties and sleep apnoea. Managing an ongoing left knee injury from netball sustained 20 years ago, tends to flare when very active/stressed. Buys takeaway and Uber Eats on the days she doesn’t have her children every 2^nd week.

Height: 162cm
Weight: 86kg
BMI: 32.8
EOSS*: Class 1, Stage 2

GP – Assesses current medications, completes CDM and MHT Plans, referral for blood test, prescribes diazepam (Valium) and celecoxib (Celebrex), organises sleep study.

Physiotherapist – Assesses left knee, notes weak gluteals and abdominals contributing to a mal-tracking patella (knee cap). Manually treats, prescribes exercises and a knee brace.

Dietitian – Notes Jo’s mixed eating habits depending on when her children are home. Discusses healthy and easy to prepare alternatives to reduce sugar/saturated fat intake.

Clinical Psychologist – Discusses Jo’s coping strategies since her divorce, commences Cognitive Behavioural Therapy and strategies to broaden her social circle locally.

Bruce, 48yo male

Former builder, now on disability pension due to workplace injury. Chronic low back pain for 5 years following a fall from 6 metres, 3 crushed lumbar vertebrae and 2 disc ruptures, required multiple surgeries and now ambulates with a stick. Manages ongoing pain with prescribed opioids, dosages now unmanaged.

History of Type 2 diabetes poorly managed, hypertension, previous trans ischaemic attack (mini stroke), coronary heart disease and hepatic steatosis (fatty liver disease). Drinks an average of 6 beers and smokes 20 cigarettes per day, suffers panic attacks and reluctance to exercise for fear of worsening low back pain.

Height: 178cm
Weight: 142kg
BMI: 44.8
EOSS*: Class 3, Stage 3

GP – Assesses current pain management with aim to reduce opioid dosage, eligible for CDM and MHT Plans, blood test, refers to Dietitian for Diabetes group sessions.

Physiotherapist – Assesses available lumbar (lower back) range, strength and function. Discusses current stability within spine, aims to build overall confidence and strength.

Dietitian – Determines that wife cooks all meals in the home, ensures she is present during consult. Discusses role of alcohol in anxiety and inflammation, plan set to reduce.

Clinical Psychologist – Seeks knowledge of lifestyle prior to and since his workplace injury. Discusses fear avoidance behaviours and strategies to manage panic attacks.

Nathan, 9yo boy

Lives with parents and younger sister, Lucy (6yo). Is in Year 3 at his local primary school and used to play soccer with his friends before being teased about his weight. Now prefers to sit by himself during recess and lunch to avoid the unwanted attention.

Has mild asthma managed with a puffer and gets tired easily. Enjoys watching cartoons after school and playing online games on his PC, as it allows him to make friends with people who don’t know him and can’t see him. Mum and Dad are concerned he isn’t spending enough time playing outside and suspect he is buying too many unhealthy snacks at the school canteen with his weekly pocket money.

GP – Assesses asthma medication, referral for blood test.

Physiotherapist – Assesses general mobility, strength, fitness. Discusses return to playing soccer.

Dietitian – Assesses snack choices and food options at home with parents present.

Clinical Psychologist – Assesses social circle and teasing at school, builds strategies to return to playing sport with friends.

* See Resources page for an explanation of the Edmonton Obesity Staging System (EOSS)