A patient with congenital absence of leptin-producing adipocytes is trying to regulate appetite. Which combined behavioral and dietary plan best compensates for absent leptin signaling to reduce long-term hyperphagia?

• A. Implement a structured program emphasizing higher-protein, higher-fiber meals at regular intervals, portion control with external cues, and increased physical activity to enhance peripheral satiety signals and reduce reliance on adiposity-derived leptin.
• B. Prescribe a very-low-fat ketogenic diet without attention to portion size, because absolute elimination of dietary fat fully replaces leptin's regulatory roles over time.
• C. Encourage unrestricted access to energy-dense snacks but increase meal frequency to every 30 minutes in order to prevent ghrelin from rising appreciably, as constant feeding mimics normal leptin feedback.
• D. Recommend periodic fasting for multiple days each week while avoiding any protein intake to allow endogenous gut hormones to fully compensate by elevating CCK and suppressing appetite chronically.

Answer: (A)