Lifestyle Interventions in a Patient Identified as Super-Super Obese With a Body Mass Index of 90.5.

Obesity is a growing global health concern. Saudi Arabia is experiencing a higher prevalence of obesity compared to the globe. This case report focuses on a 38-year-old female with a body mass index (BMI) of 90.5 kg/m2, prediabetes, and obstructive sleep apnea who successfully underwent a lifestyle modification process resulting in remarkable weight loss. The patient's past unsuccessful attempts at weight loss had left her with a reluctance to try again initially. A multidisciplinary team collaborated to develop a management plan starting with an intensive lifestyle intervention. Lifestyle was assessed, then a structured personalized lifestyle intervention based on a plant-based diet and a gradual increase in physical activity was implemented. Over 6 months, the patient succeeded in losing 23 kg, a percent weight loss of 11.9%. An additional 5 kg was lost when liraglutide "Saxenda" was added. This case report represents the effectiveness of intensive lifestyle interventions in patients with super-super obesity for weight loss and long-term health improvement. Additional research is required to determine if the positive outcomes seen in treating a single patient can be applied to a larger population with super-super obesity. This brings up the question of whether pharmacotherapy or surgical interventions should be the primary approaches for addressing these cases, considering that surgical interventions usually involve lifestyle changes. What we already know about such cases: patients with super-super obesity often require interventions such as surgery or medication to aid in weight reduction, as they typically do not respond to lifestyle interventions alone. What this case report adds to existing knowledge: the use of lifestyle interventions proved effective in such cases as super-super obesity and delayed the need for surgical intervention even without weight reduction medications.

Experience of establishing a lifestyle medicine clinic at primary care level- challenges and lessons learnt.

On an international level, for more than 30 years, Lifestyle Medicine (LSM) Practice has had a great impact on both health Promotion and disease prevention. A practice which on a national KSA level, we are in eager need to adopt, due to the high prevalence of chronic diseases and unhealthy lifestyles. The establishment of the LSM clinic inside the Wazarat Health Center (WHC) more than one and half year ago, was a great advancement towards offering very important preventive and promotive services for people in real high need to these underutilized main elements in Primary Health Care (PHC) features. We identified quality oriented Key Performance Indicators and the clinically important outcomes for our patients. Our initial data showed great achievement on both fronts. We are currently studying the satisfaction of our customers and working on improving their level of health awareness and help seeking behavior. Furthermore, we are looking to benchmark our results. From our pilot project in WHC, we are preparing for an expansion plan to branch out other Primary Care centers in the Riyadh area to serve more people, and we aim to share the experience with other similar services and within the PHC centers allover KSA.