Nutritional assessment was administered to approximate caloric intake and diet macronutrient composition (Quick Check for Dietary Progress, Nutrition Scientific, Pasadena, CA). The patient consumes approximately 1940 calories per day; saturated and total fat intake are approximately 11.2% and 34% of total calories; by 7-day food records, protein intake is estimated to be 22% of calories and carbohydrate intake is 44% of calories.
Fiber intake was estimated and found to be approximately 12.5 grams per day. She consumes an average of only 2-3 fruit and vegetable servings and 3-4 whole grain servings per day. Dairy intake averaged one serving per day of 2% milk or regular cheese.
She reports low water consumption (3-4 eight ounce glasses) per day and only occasionally includes legumes in her diet.
She consumes a significant amount of regular snack foods consisting mostly of commercial cookies, potato chips, and pretzels. She often skips breakfast and eats dinner late. She snacks 2-3 times per day and often consumes popcorn, potato chips, or ice cream immediately prior to bedtime. When she does eat breakfast, it usually consists of eggs and bacon or a cheese and sausage omelet with home-fried potatoes. She estimates eating out four times per week, three at fast food restaurants, which has been shown to be associated with weight gain. 
High fat, high saturated fat, high sodium diet; low in complex carbohydrates and fiber; skips breakfast; eats out frequently.
Increased complex CHOs and high fiber foods, including, in particular more fruits/vegetables, whole grains, and beans/legumes; decreasing fast food and whole/2% dairy consumption; drink more water; calorie reduction.