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A 17-year-old morbidly obese male (BMI > 42) presents for a 6 month follow-up visit for elevated fasting cholesterol and LDL. He has a strong family history of early onset cardiovascular disease with multiple family members having myocardial infarctions before the age of 55 years, including his father. His total cholesterol is extremely high, and his LDL is 170 (normal < 100). He has attempted vigorous lifestyle modification in the last 12 months with no changes in his total cholesterol and LDL. What would you consider next in the management of this adolescent? Group of answer choices
A. Continue with life style modifications for another 6 months.
B. Begin treatment of his elevated cholesterol with a statin or resin.
C. Explain that he must lose weight since there are no medications for adolescents that can treat elevated LDL levels.
D. Explain that unless his LDL is over 190, he is not a candidate for treatment.
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