Weight management case study

33-year-old male construction worker.  Lives with his wife.  On track for high-risk chronic disease with severe obesity at a young age.

• Past Medical History: Class 3 Obesity (weight: 317 lbs, BMI: 40.3 on 3/28/2024), high blood pressure (170+ systolic), gout, sleep apnea
• Social History: No tobacco use, social alcohol consumption
• Status at Enrollment:
  • Severe obesity
  • Uncontrolled high blood pressure despite three medications
  • Active construction job and attempts to walk with his wife in the evening
  • Little focus on nutrition and overall caloric intake – consumes junk food, fried foods, sugary drinks, and alcohol regularly
• Medications:
  • High Blood Pressure: Amlodipine, Ramipril, Hydralazine
  • Obesity: Zepbound
• Interventions:
  • Upon enrollment, Pharmacist uncovered consistently uncontrolled high blood pressure
    • Coordinated with the provider to schedule the patient an appointment for evaluation and medication review in the office
  • Pharmacist also monitored initiation, tolerability, titration, and outcomes associated with Zepbound therapy.
  • Health Coach engaged and collaborated with the patient to establish initial weight loss goal of 250 lbs and established achievable lifestyle changes
    • As goals were achieved (weight, nutrition, exercise), the Health Coach continued to guide him to the next phase of his health.
• Outcomes:
  • Achieved a weight of 185 lbs in 9 months – 135 pounds lost!
  • Started at size 3XL shirt and 42 in waist pants Achieved size M shirt and 32 in waist pants
  • Blood pressure normalized (120/80) and eliminated one medication
  • Gout completely resolved
  • Sleep significantly improved and wife validated he was no longer snoring or experiencing sleep disruptions
  • Meal planning each week, monitoring portion sizes and in control of what he consumes – one large meal per day with several smaller ones (protein bar/shake with fruit)
  • Working out at the gym 2X per day – blending cardio exercise with strength training noticeable muscle definition
• Impact:
  • Patient is a young man on track for significant health disparities early in life the program provided an opportunity to invest in his health and completely changed his trajectory.
  • After a year in the program, he stated that his health habits felt sustainable long-term.
  • “I feel the best I’ve felt in as long as I can remember – energy, mobility, pretty much in every physical capacity!”