Review Health History: Collect detailed information about his lifestyle (diet, exercise, stress, sleep), family history (hypertension, diabetes, cardiovascular diseases), and emotional health. Physical Exam: Measure his waist-to-hip ratio, perform a cardiovascular assessment, and check for any signs of metabolic syndrome. Labs: Order blood tests to assess kidney function (e.g., serum creatinine), lipid profile, and HbA1c for a more accurate picture of his glucose control.

Physical Health: Assess her diet, physical activity, and sleep quality. Conduct a physical exam to check for metabolic syndrome and order blood tests (e.g., fasting glucose, lipid panel, thyroid function). Emotional Health: Use screening tools like the PHQ-9 for depression and GAD-7 for anxiety. Discuss her sources of stress and emotional triggers, and explore coping mechanisms. Spiritual Health: Ask Mary about her sense of purpose, community connections, and whether she engages in any spiritual practices (e.g., meditation, prayer, volunteering).

Build Rapport and Trust: Acknowledge Sarah’s concerns about her medications and empathize with her desire for a more natural approach. Collaborative Goal Setting: Work with Sarah to set realistic, measurable goals, such as losing 5% of her body weight, improving blood pressure to <140/90, and normalizing blood sugar levels. Lifestyle Interventions: Diet: Recommend a balanced, nutrient-dense diet with emphasis on whole foods and reduced sugar.

Evaluate Current Health Status: Check Tim’s recent blood pressure and cholesterol readings. If they are stable and within normal ranges, he may be a candidate to reduce or eliminate medications. Implement Lifestyle Changes: Diet: Recommend a heart-healthy diet (e.g., DASH diet), focusing on fruits, vegetables, whole grains, and healthy fats. Reduce sodium intake to under 1,500 mg/day.