Methods
Assessment of lifestyle ”Vital Signs”
All six pillars of lifestyle medicine were assessed. No physical
activity or muscle strengthening exercise engagement during the week and
most of the time spent sitting or reclining at home even. There were
objective evidence major mobility limitations on a 400-m walk test and
climbing one flight of stairs.
Regarding nutrition, on a typical day the patient was highly consuming
sugary food/drinks and ultra-processed foods and minimal consumption of
fruits and vegetables/day.
Sleep was for short periods interrupted and during the day. She usually
gets four to five interrupted unrefreshed sleeping hours during the day.
She was not a smoker or substance abuser and had limited social
connections. Her mental health was reasonable.
Lifestyle interventions
The intervention aimed to create a negative energy balance through
reduced calorie consumption by a plant-based diet avoiding processed
food and increasing energy expenditure through gradual physical
activity. Walking was added to the patient’s daily schedule starting
with 2 minutes 3 times per day then progressing gradually. Sleep was
increased up to 6 hours per night. Family support had a big role in
patient weight loss success. The patient was hospitalized 5 days/ week
at her sister’s home where she ensures compliance.