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Thomas is a 16-year-old male who lives in an inner-city apartment with his sister Keisha who is 21 and Keisha's 3-year-old son. His mother passed away 10 years ago from complications associated with uncontrolled diabetes and obesity. Thomas moved-in with Keisha, who became his legal guardian. During his annual exam at clinic, it is noted that Thomas has gained 60 pounds in the last year. He is 5 feet, 11 inches and now weighs 240 pounds. He recently changed schools due to peer bullying and violence. He reveals to the nurse and physician during the physical that he has not made any friends in the new school. He also reveals to the clinic nurse that he has been skipping school and spends most of his time alone playing video games and watching television. He states that "Everyone would be better off without me."
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