A 52-year-old White male presents to his primary care physician for his annual exam. The patient is 6 ft tall and weighs 265 lb, with a BMI of 35.9. His heart rate is 82 beats/min, and his blood pressure is 175/90 mm Hg. He states that his weight has gone up steadily over the past several years and that he has gained 45 lb in the past 3 years. He notes that he has had little motivation to exercise since he lost his brother to suicide 4 years ago. He has never seen a therapist.