<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 42-year-old woman comes to the physician for a routine health maintenance examination. She has generalized fatigue and has had difficulties doing her household duties for the past 3 months. She has eczema and gastroesophageal reflux disease. She has a history of using intravenous methamphetamine in her youth but has not used illicit drugs in 23 years. Her medications include topical clobetasol and pantoprazole. She is 160 cm 5 ft 3 in tall and weighs 105 kg 231 lb; BMI is 42 kgm2. Her temperature is 37C 98.6F, pulse is 95min, and blood pressure is 14590 mm Hg. The lungs are clear to auscultation. Cardiac examination shows no abnormalities. Pelvic examination shows a normal vagina and cervix. Laboratory studies show:Hemoglobin 13.1 gdLLeukocyte count 7,800mm3Platelet count 312,000mm3SerumNa 141 mEqLK 4.6 mEqLCl- 98 mEqLUrea nitrogen 12 mgdLFasting glucose 110 mgdLCreatinine 0.8 mgdLTotal cholesterol 269 mgdLHDL-cholesterol 55 mgdLLDL-cholesterol 160 mgdLTriglycerides 320 mgdLUrinalysis is within normal limits. An x-ray of the chest shows no abnormalities. She has not lost any weight over the past year despite following supervised weight loss programs, including various diets and exercise regimens. Which of the following is the most appropriate next step in management of this patient?? A: Liposuction, B: Metformin and statin therapy and follow-up in 3 months, C: Bariatric surgery, D: Behavioral therapy, E: Phentermine and topiramate therapy and follow-up in 3 months,  <response>: This is a question about the appropriate management for a 42-year-old obese woman with fatigue, difficulty with household duties, and multiple comorbidities including eczema, gastroesophageal reflux disease, dyslipidemia, and prediabetes. She has tried supervised weight loss programs including diets and exercise without success. The choices include liposuction, metformin and statin therapy, bariatric surgery, behavioral therapy, and phenterminetopiramate therapy.Liposuction would not be appropriate as it removes subcutaneous fat but does not treat obesity or its associated comorbidities. Metformin and statin therapy may help manage her prediabetes and dyslipidemia but do not address her obesity which is likely contributing to her symptoms. Bariatric surgery can be an effective treatment for obesity in appropriate candidates who have not responded to lifestyle modifications. Behavioral therapy alone is not likely to lead to significant weight loss based on her lack of success with supervised weight loss programs. Phenterminetopiramate can promote weight loss but needs close monitoring for side effects.C: Bariatric surgery 