Description

A.C. is a 17-year-old high school senior with a chief complaint of increased fatigue for the past 2 months. Reports feeling frustrated, irritable, and experiencing daily crying episodes over past month. Reports decline in school performance and lack of interest in usual activities. Reports unintentional weight gain of 25-30 pounds over the past year. Diet is often pizza and french fries, and skips breakfast. Physical exam findings of elevated BMI and tearfulness. Has acne, abdominal and buttocks striae, and acanthosis nigricans. Denies any active suicidal thoughts.