Weight Management in Obesity: A Detailed Case Study Presentation

This presentation provides a detailed case study of a 56-year-old patient admitted to the hospital with obstructive sleep apnea, extreme hypertension, palpitations, and chest pain, all potentially linked to obesity. The presentation covers the patient's history, including social and medical aspects, family history, and a review of systems. Objective data such as vital signs, BMI, and blood sugar levels are analyzed. Differential diagnoses, including hypertension, metabolic syndrome, and Cushing’s syndrome, are explored before arriving at a diagnosis of obesity based on BMI and hip-to-waist ratio. A comprehensive diagnostic workshop, risk factors, and a detailed treatment plan involving pharmacological interventions, lifestyle modifications, and patient education are outlined. The presentation also includes research article information, follow-up strategies, and specific goals for the patient's recovery, such as reducing blood pressure and improving BMI. Referrals to diet experts, lifestyle instructors, gym instructors, psychologists, and self-help groups are recommended to support the patient's journey toward better health. The presentation concludes by emphasizing the importance of weight management in reducing the risks associated with obesity and related co-morbidities.

August 29, 2
024
1
Weight
Management
For Obesity

August 29, 20242
Objectives
 To properly understand the different
complications related to obesity by case
presentation
 To evaluate patient’s subjective and objective
data related to obesity
 To discuss about differential and eventual
diagnosis of the disease
 To outline details regarding strategies to treat
people with obesity related complications

August 29, 20243
What is obesity?
 Obesity is a condition when an
individual has a weight that is
considered to be higher than normal.
This can be screened using the Body
Mass Index and Hip to Waist ratio.
 For adults, a BMI above 30 and a hip to
waist ratio above 0.90 is considered
obese

August 29, 20244
Prevalence of Obesity
 Since 1975, the global prevalence of
obesity has tripled.
 As of 2016, more than 650 million adults
(worldwide) were found to be obese
(13% of adults).
(who.int, 2018)
 In the US, 39.8% of adults (93.3 million
people) were Obese (cdc.gov, 2018).

August 29, 20245
History of patient’s illness
 Patient is 56 year old who was admitted to
hospital after a diagnosis of Obstructive
Sleep Apnea, Extreme Hypertension,
Palpitation and complaints of chest pain.
 The patient also complained of excessive
fatigue, lack of sleep, irritability and
frequent headaches.
 The patient’s work is getting affected due
to these conditions.

August 29, 20246
Social History
 The patient is employed as a store accountant and
spends most of his time working in front of the
computer, and gets very little physical activity.
 The patient is married for 20 years, and has one
daughter who studies abroad
 The patient is a regular smoker (smokes 20
cigarettes a day) and drinks heavily (about 3.5
litres of whiskey every week).
 His diet is very irregular and he mostly orders a lot
of fast food every day.

August 29, 20247
Medical History
 Even though the patient complains of
chronic fatigue, restlessness, and chest
pain, there is no record of heath service
record for the last 6 months. The patient
said his problems became unmanageable
over the last couple of weeks, due to
which he was admitted to hospital.
 For obstructive Sleep apnea, he was
using a CPAP mask since last year.

August 29, 20248
Family History
 Mother: Hypertension (deceased age 60)
 Father: Dabetes Type 2 (deceased age 70)
 Paternal Grandmother: Cancer (deceased, age
50)
 Paternal Grandfather: Unknown
 Maternal Grandfather: Stroke (Deceased, 79)
 Maternal Grandmother: Alive and healthy

August 29, 20249
Review of Systems
 Visual: Normal vision. The patient does not have
any eye complications, and does not wear glasses
or contact lenses.
 Auditory: No auditory problems
 Oropharyngeal: No problem chewing or
swallowing food.
 Cardiac: Hypertension and mild chest pain
towards the left side of the chest.
 Respiratory: Patient does not have any cough or
asthma. The patient is suffering from Obstructive
Sleep Apnea

August 29, 202410
 Gastrointestinal: Patient denied constipation, nausea,
vomiting or any other gastrointestinal problems.
 Genitourinary: No genitourinary complication
 Musculoskeletal: Patient denies of any
musculoskeletal problems or any problems with
mobility or range of movement.
 Neurological: Patient denied any neurological
condition
 Psychiatric: Patient complained of constant fatigue
due to inadequate sleep.
 Integumentary: No problems with skin.

August 29, 202411
Objective Data
 Vital Signs:
 Blood Pressure: 180/120
 Pulse Rate: 110
 Body Mass Index: 35
 Hip to waist ratio: 0.95
 Blood Sugar:
 Normal Blood Sugar: 98 mg/dl
 Postprandial blood sugar: 135 mg/dl
 Fasting blood sugar: 90mg/dl
 Triglyceride level: 160mg/dl

August 29, 202412
Physical Assessment
 Head: Atraumatic, normocephalic.
 Ears: No exudates or drainage from the ear canal. Tympanic
membrane is intact. No bulging or erythema to indicate infection.
Hearing is intact.
 Eyes: Normal vision, and no vision problems. No discharge.
 Nose: No discharge, deformity of bleeding from nose
 Oral Cavity: Lip and teeth normal, Oral mucosa is moist and pink,
Uvula is elongated, airways slightly obstructed, normal voice, no
stridor.
 Neck: Neck is supple, signs of jujular vein distention on both sides
of neck, signs of neck bruits. Trachea is midline
 Chest: Slight chest pain towards left side, symmetrical and equal
breath sounds
 Lungs: CTA bilateral, no wheezing sounds or rales or ronchi.