Patient description: The patient is a 32-year-old obese woman who came to the clinic with weight concerns. She is 165 cm tall and her weight is 113 kg. She is complaining of sleep apnea, PCO and dissatisfaction with her body shape. She is a high-school teacher married for 5 years. She doesn't use any contraceptive methods for the past 4 months and she had no prior pregnancies. She doesn't smoke or use any drugs. She likes to try diets and exercise to lose weight. She completed the four square step test in 14 seconds. Her BP: 130/80, HR: 195/min and her BMI is: 41.54. Her labs: FBS: 98 mg/dl TG: 150 mg/dl Cholesterol: 180 mg/dl LDL: 90 mg/dl HDL: 35 mg/dl Her cardiac assessment is normal. Her joints and ROM are within normal.

Clinical trial eligibility criteria: eligible ages (years): 21.0-999.0,  Intermittent Claudication Arteriosclerosis Adults greater than or equal to 21 years. 2. Limiting lower limb intermittent claudication due to infra-inguinal obstructive atherosclerosis, not optimal for catheter-based treatment. 3. Patient femoral artery inflow by radio contrast or magnetic resonance angiography within the previous 12 months. 4. Stable symptoms for at least 4 months. 5. Peak walking time (PWT) on standardized Gardner Exercise Treadmill Exam between 1 and 12 minutes. 6. Resting ankle-brachial systolic blood pressure index (ABI) less than 0.9 in the more-affected limb. 7. Bilateral PAD for subjects enrolled into Strata C-F with the less-affected limb having any of the following Resting or post-exercise ABI less than or equal to 0.9 Typical intermittent claudication Infrainguinal obstructive atherosclerosis in a femoropopliteal and/or tibial artery greater than or equal to 70%. Subjects enrolled into Strata A and B may have both unilateral or bilateral peripheral atherosclerotic disease  Any history of malignancy or a known genetic predisposition for developing cancer except for curatively resected basal cell carcinoma of skin, squamous cell carcinoma of skin, cervical carcinoma in situ, or resected benign colonic polyps. 2. Non-compressible arteries (resting ankle-brachial systolic blood pressure index (ABI) greater than 1.3 in the more-affected limb). 3. Evidence of malignancy after screening according to modified American Cancer Society Guidelines in the following organ systems (screening procedures in addition to history and physical exam are noted): -Prostate: subjects with the following PSA levels above the recommended age-specific cut-points will be excluded Age 50-59 greater than or equal to 3.7 Age 60-69 greater than or equal to 5.1 Age 70-79 greater than or equal to 7.0 Age 80 plus-greater than or equal to 7.2 Subjects with PSA values above the age-specific cut-points are eligible if a prostate biopsy, within 12 months, shows neither prostate cancer nor high-grade prostatic intraepithelial neoplasia (PIN) Breast: mammogram Cervix: Pap smear Colon: Colonoscopy Skin Lung: contrast chest CT scan 4. Proliferative retinopathy, severe non-proliferative retinopathy, advanced age-related macular degeneration, especially subjects with chorodial neovascularization, diabetic retinopathy, macular edema, or intraocular surgery within 3 months. 5. Limiting symptom on Gardner Exercise Treadmill Examination other than intermittent claudication. 6. Co-morbid conditions that limit exercise capacity Severe arthritis affecting lower extremities Severe chronic obstructive pulmonary disease Angina pectoris greater than Canadian Angina Class 2 Dyspnea greater than New York Heart Association Class II 7. Cardiovascular surgery or percutaneous revascularization within 4 months