Intensive lifestyle interventions in the management of chronic conditions and obesity: a case report

Abstract

Intensive interventions based on the pillars of Lifestyle Medicine (SEM) have demonstrated efficacy in the management of chronic conditions and obesity. This report describes the evolution of a 61-year-old morbidly obese patient, initially planning bariatric surgery, who chose to adopt a SEM approach to manage his health.
The patient OFP, 61 years old, was admitted to the Rituaali Clinic on 01/23/2024, weighing 150.2 kg, height of 1.74 m, BMI of 49.04, blood pressure of 160x99 mmHg, HR of 78 bpm and abdominal circumference of 154 cm. The initial objective was to prepare for bariatric surgery, however, at the end of the 14-day hospitalization, the patient decided to cancel the surgery and continue treatment through the Continuous Monitoring Program (PAC) based on MEV, under CAAE No. 66217922.0.0000.5244. The patient was monitored by a multidisciplinary team composed of a nutritionist, physician, physiotherapist, and psychologist, focusing on the 6 pillars of MEV: healthy eating, regular physical activity, stress management, restful sleep, healthy social relationships, and abstinence from harmful substances. After 24 weeks of follow-up, in August 2024, the patient showed a significant reduction in weight (from 150.2 kg to 120 kg), HbA1c from 6.3% to 5.8%, BMI from 49.04 to 39.18. Abdominal circumference decreased from 154 cm to 120 cm, reflecting improved metabolic control. In addition to weight loss, carotid ultrasound showed a reduction in intima-media thickness, indicating improved vascular health. Abdominal ultrasound also demonstrated a reduction in abdominal and liver fat, suggesting a positive impact of lifestyle changes on the patient’s metabolic conditions. This case highlights the effectiveness of intensive lifestyle interventions in the management of obesity and chronic diseases. Continuous monitoring and support from a multidisciplinary team were essential to empower the patient to make healthy and sustainable choices, leading to significant improvements in his metabolic and cardiovascular health, without the need for bariatric surgery.