Rosa is 37 years old, 5 ft 4 in tall, and the mother of two children. Before her first child was born 10 years ago, her normal weight was 140 pounds. She gained 35 pounds during pregnancy and didn't regain her normal weight before her second pregnancy a year later. She is now at her heaviest weight of 168 pounds, She complains of fatigue and thinks her weight contributes to her asthma, She has tried several diets and has been unable to take weight off and keep it off. Her doctor told her she has prehypertension and encouraged her to lose weight to lower both her blood pressure and serum glucose levels The fear of needing medication for hypertension or diabetes has motivated her to lose weight.