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Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2)
Obesity causes and exacerbates many disease processes and affects every organ system. Thus it is not surprising that clinical providers are often overwhelmed with the multitude of symptomatology upon initial presentation in patients with obesity. However, despite a “complicated medical history,” a s...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783492/ https://www.ncbi.nlm.nih.gov/pubmed/31632343 http://dx.doi.org/10.3389/fendo.2019.00635 |
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author | Srivastava, Gitanjali Apovian, Caroline M. |
author_facet | Srivastava, Gitanjali Apovian, Caroline M. |
author_sort | Srivastava, Gitanjali |
collection | PubMed |
description | Obesity causes and exacerbates many disease processes and affects every organ system. Thus it is not surprising that clinical providers are often overwhelmed with the multitude of symptomatology upon initial presentation in patients with obesity. However, despite a “complicated medical history,” a systematic, organized approach in obesity medicine utilizes a personalized-tailored treatment strategy coupled with understanding of the disease state, presence of comorbidities, contraindications, side effects, and patient preferences. Here, we present the case of a young patient with Class 3b severe obesity, several obesity-related complications, and extensive psychological history. Through synergistic and additive treatments (behavioral/nutritional therapy combined with anti-obesity pharmacotherapy and concurrent enrollment in our bariatric surgery program), the patient was able to achieve significant −30.5% total body weight loss with improvement of metabolic parameters. Though these results are not typical of all patients, we must emphasize the need to encompass all available anti-obesity therapies (lifestyle, pharmacotherapy, medical devices, bariatric surgery in monotherapy or combination) in cases of refractory or severe obesity, as we do similarly for other disease modalities such as refractory hypertension or poorly controlled Type 2 diabetes that requires robust escalation in therapy. |
format | Online Article Text |
id | pubmed-6783492 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-67834922019-10-18 Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2) Srivastava, Gitanjali Apovian, Caroline M. Front Endocrinol (Lausanne) Endocrinology Obesity causes and exacerbates many disease processes and affects every organ system. Thus it is not surprising that clinical providers are often overwhelmed with the multitude of symptomatology upon initial presentation in patients with obesity. However, despite a “complicated medical history,” a systematic, organized approach in obesity medicine utilizes a personalized-tailored treatment strategy coupled with understanding of the disease state, presence of comorbidities, contraindications, side effects, and patient preferences. Here, we present the case of a young patient with Class 3b severe obesity, several obesity-related complications, and extensive psychological history. Through synergistic and additive treatments (behavioral/nutritional therapy combined with anti-obesity pharmacotherapy and concurrent enrollment in our bariatric surgery program), the patient was able to achieve significant −30.5% total body weight loss with improvement of metabolic parameters. Though these results are not typical of all patients, we must emphasize the need to encompass all available anti-obesity therapies (lifestyle, pharmacotherapy, medical devices, bariatric surgery in monotherapy or combination) in cases of refractory or severe obesity, as we do similarly for other disease modalities such as refractory hypertension or poorly controlled Type 2 diabetes that requires robust escalation in therapy. Frontiers Media S.A. 2019-10-02 /pmc/articles/PMC6783492/ /pubmed/31632343 http://dx.doi.org/10.3389/fendo.2019.00635 Text en Copyright © 2019 Srivastava and Apovian. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Srivastava, Gitanjali Apovian, Caroline M. Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2) |
title | Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2) |
title_full | Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2) |
title_fullStr | Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2) |
title_full_unstemmed | Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2) |
title_short | Clinical Challenge: Patient With Severe Obesity BMI 46 kg/m(2) |
title_sort | clinical challenge: patient with severe obesity bmi 46 kg/m(2) |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783492/ https://www.ncbi.nlm.nih.gov/pubmed/31632343 http://dx.doi.org/10.3389/fendo.2019.00635 |
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