Her support networks are poor, and she prefers a lonely life, and thus it can be suspected that she is isolated due to her depression (Wiederman and Pryor, 2000).
Obviously, her diet is disproportionate to her requirement, and the excess calorie in her diet is contributing to her weight gain. From the history it is apparent that she is binge eating, and given her psychological history, it may be a case of bulimia nervosa (Schlesier-Carter et al., 1989). Since she is ready for a change, a dietary analysis would be needed to examine the imbalance between her current dietary pattern and the requirement for her age, profession, and stature. More importantly, if she is going to an exercise regimen, it would be needed to advise her how much weight she must reduce (Grilo, Masheb, and Berman, 2001). This can be done through the reduction of caloric requirement, and the new dietary advice must contain the maximum permissible calories without affecting the energy requirement. Since bulimia is the suspected cause, there must be provision for handling these issues through appropriate psychotherapeutic interventions (Stice and Fairburn, 2003).
As per UK reference values, Susan belongs to the adult age group, and hence her energy requirements are lower, so are the requirements of energy will be lower, although they vary according to age, gender, and activity level. With the data provided, Susan's BMI would be 30.86, which as per references is class I obesity (Buttriss, 2000). Taking the ideal BMI to be 20 to 24.9, for Susan, it would be ideal to keep a target of 22 as the BMI, and to achieve that she will have to bring her weight back to 56 kg. This means she will have to lose about 23 kg of weight. She is a secretary by profession, hence her lifestyle may be considered as sedentary. Diet analysis of Susan indicates that she has consumed 2765.24 Kcal on an average per day (Swan, 2004). This comes from on an average of 672 g of carbohydrate and related food consumed including sugar and starch. According to DRV, this itself is higher since this should be (50 + 10) % to (47 + 11)% maximum. Although the average British intake is higher, since Susan is overweight she needs to reduce the energy intake by about 1000 kcal a day so over a period of 23 weeks, she will achieve the target weight (Ruxton et al., 1996). Since there is a program for physical activity, an exercise programme comprising of brisk walking and running at a speed of 10 minutes a mile would cause a total loss of 375 kcal per day. Having this allowance based on DRV, her energy requirement may be adjusted to omission of fatty food totally and carbohydrate restriction to 200 g (Millward, 2004). Moreover, her protein consumption is within normal limits. Apart from that, she has problems with other micronutrient consumption (Millward, 2004). Her average consumption of phosphorus, magnesium, chloride, zinc, copper, iodine, selenium, nicotinic acid, vitamins A, C, D, vitamin E are not normal, and the diet must be planned in such a way that she has the appropriate daily allowances of these elements. Calcium should be 700 mg/day, Phosphorus 550 mg/day, Magnesium 270 mg/day, Sodium 1600 mg/day, Potassium 3500 mg/day, chloride 2500 mg/day iron 14.8mg/day, copper 12 mg/day, Selenium 60 mcg/day, iodine 140 mcg/day, thiamine 0.8 mg/day, riboflavin 1.1 mg/day, Niacin 13 mg/day, Vitamin B6 1.2 mg/day, Vitamin B12 1.5 mcg/day, folate 200