Metabolic Syndrome: This condition is characterized by a cluster of symptoms including high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. Given the patient's age, height, weight (274lbs at 70 inches), and the combination of elevated cholesterol, LFTs (indicative of liver dysfunction which can be associated with fatty liver disease), elevated BUN (which could indicate renal impairment), and elevated TSH (suggesting hypothyroidism), metabolic syndrome is a plausible diagnosis. The patient's obesity is a significant risk factor for developing this syndrome.

Hypothyroidism: Elevated TSH levels are a direct indicator of primary hypothyroidism. This condition can contribute to elevated cholesterol levels and may also affect liver function tests and contribute to weight gain, further complicating the patient's obesity.
Non-Alcoholic Fatty Liver Disease (NAFLD): Given the patient's obesity and elevated LFTs, NAFLD is a likely diagnosis. NAFLD can range from simple steatosis to non-alcoholic steatohepatitis (NASH) and is closely associated with metabolic syndrome.
Chronic Kidney Disease (CKD): The elevated BUN could indicate impaired renal function. CKD is associated with metabolic syndrome and can also contribute to or exacerbate hypertension and dyslipidemia.

Thyroid Cancer or Other Thyroid Pathology: Although less common, significantly elevated TSH levels warrant further investigation to rule out thyroid cancer or other thyroid pathologies that could have systemic effects, including on metabolism and liver function.
Primary Liver Diseases: Such as autoimmune hepatitis, primary biliary cirrhosis, or hemochromatosis, which could explain the elevated LFTs and have systemic implications.
Polycystic Kidney Disease (PKD): A genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys, which could lead to elevated BUN and has implications for kidney function and hypertension.

Familial Hypercholesterolemia: A genetic disorder characterized by very high levels of LDL cholesterol, which could explain the elevated cholesterol but would not directly account for the other findings.
Wilson's Disease: A rare genetic disorder characterized by excessive accumulation of copper in the body, particularly in the liver, brain, and other vital organs. It could explain the elevated LFTs but is less likely given the patient's presentation and the other findings.
Cushing's Syndrome: A rare endocrine disorder caused by excess cortisol levels, which can lead to weight gain, hypertension, and dyslipidemia, among other symptoms. It could potentially explain some of the patient's findings but is less common and would require specific diagnostic testing.