Case History/Examination
A 38-year-old female does not know to have any medical illness presented
to obesity clinic at primary care for weight management. She was brought
by her sister and aunt to the clinic because she was partially willing
to lose weight. She did not undergo a structured weight-loss trial
before. Her vital signs were height 146 cm, weight 193 kg, body mass
index (BMI) 90.5 kg/ m2 with central obesity. Her
blood pressure was normal with a regular pulse. All her laboratory work,
other than high normal blood sugar, was normal. Therefore, metformin
started. In addition, she had obstructive sleep apnea and c-pap started.
A multidisciplinary team was formed to discuss the case including
preventive medicine, family medicine, diabetologist, endocrinologist,
bariatric surgeon, and health coach. Both preventive and family medicine
physicians had lifestyle medicine training along with the health coach.
We suggested starting a structured lifestyle style intervention for six
months then adding weight loss medications ‘’Liraglutide” then going
for surgery.