Patient description: The patient is a 34-year-old obese woman who comes to the clinic with weight concerns. She is 165 cm tall, and her weight is 113 kg (BMI: 41.5). In the past, she unsuccessfully used antiobesity agents and appetite suppressants. She is complaining of sleep apnea, PCO and dissatisfaction with her body shape. She is a high-school teacher. She is married for 5 years. She doesn't use any contraceptive methods for the past 4 months and she had no prior pregnancies. She rarely exercises and movement seems to be hard for her. She is not able to complete the four-square step test in less than 15 seconds. She does not smoke or use any drugs. Her BP: 130/80, HR: 195/min and her BMI is: 41.54. Her lab results: FBS: 98 mg/dl TG: 150 mg/dl Cholesterol: 180 mg/dl LDL: 90 mg/dl HDL: 35 mg/dl She is considering a laparoscopic gastric bypass.

Clinical trial eligibility criteria: eligible ages (years): 25.0-70.0,  Obesity Male or female 25-70 years of age 2. Obese (BMI ≥ 30 kg/m2 and <40 kg/m2) 3. At least 2 cardiovascular risk factors (diabetes, hypertension or dyslipidemia) i) Hypertension defined by a history of hypertension, treatment of hypertension or BP values >140/90 mmHg in two consecutive office visits ii) High cholesterol defined by an LDL-C ≥130 mg/dL and/or HDL-C <40 mg/dL and triglycerides ≥150 mg/dL iii) Type 2 Diabetes Mellitus defined by a history of diabetes, treatment of diabetes or fasting glucose ≥126 mg/dL in two consecutive office visits 4. Participant must be willing and able to provide written informed consent 5. Participant must be willing and able to comply with study related procedures 6. Participant must have access to Internet and e-mail  Stage 1 or 2 on Patient Activation Measures tool 2. Weight change of more than 5 kg during the 3 months preceding the screening visit 3. History of bariatric surgery 4. Fasting Plasma Glucose at screening > 250 mg/dL (> 13.9 mmol/L) 5. Hemoglobin A1c at screening >8.5% 6. Treatment of type 2 diabetes with insulin (except for history of intermittent acute use, no more than 2 weeks usage in previous 6 months) 7. Uncontrolled or inadequately controlled hypertension at the time of screening with blood pressure >160/100 mmHg 8. Secondary hypertension 9. Changes in lipid, blood pressure or diabetes modifying agents including introduction, change in dose or cessation in the 3 months prior to Screening Visit 10. Personal history of coronary heart disease, congestive heart failure, serious arrhythmias and stroke 11. Cardiovascular, hepatic, neurological, endocrine disease, active malignant tumor or other major systemic disease making implementation of the protocol or interpretation of the study results difficult. 12. Presence of any condition (medical, psychological, social, or geographical), actual or anticipated, that in the opinion of the Investigator would restrict or limit the patient's successful participation for the duration of the study 13. Presence of history of cancer within the past five years with the exception of adequately treated localized basal cell skin cancer or in situ uterine cervical cancer 14. Use of systemic glucocorticoids (excluding topical application or inhaled forms) for one week or more within 3 months prior to the time of screening 15. Use of any investigational agent (drug, biologic, device) within 3 months prior to screening