PD663 - VERY-LOW-CALORIE-DIET, TIRZEPATIDE, AND BARIATRIC SURGERY: A MULTIDISCIPLINARY SUCCESS IN SUPER-SUPER OBESITY

PD663

VERY-LOW-CALORIE-DIET, TIRZEPATIDE, AND BARIATRIC SURGERY: A MULTIDISCIPLINARY SUCCESS

IN SUPER-SUPER OBESITY

C. Daou^1,*

¹Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

Rationale: Obesity is a chronic disease with increasing global prevalence. Recent advancements in obesity treatment include surgical and pharmacological managements. Despite these developments, managing super-super obesity remains complex, often requiring a multidisciplinary approach. This case highlights the multidisciplinary team (MDT) approach in managing a 49-year-old male with super-super obesity

Methods: A 49-year-old male with severe obesity was evaluated in a bariatric clinic for surgical management. Bariatric surgery was deferred for six months to allow preoperative optimization, targeting approximately 10% weight loss. Interventions included a very-low-calorie diet (VLCD), pharmacotherapy with tirzepatide, physical therapy, and MDT input. Following optimization, the patient underwent laparoscopic sleeve gastrectomy (LSG)

Results: Prior to surgery, the patient achieved a weight reduction of 70 kg (from 272 kg to 202 kg; BMI 78.9 kg/m²), corresponding to 26% excess weight loss within six months. Glycemic control improved significantly, with HbA1c decreasing from 8.8% to 5.3%. Nutrition-related laboratory parameters, including vitamins D, A, and E, normalized with supplementation. Following LSG, further weight loss was observed, reaching 175 kg (BMI 68.36 kg/m²), with a total excess weight loss of 37% since admission. Functional status improved markedly, with the patient able to stand one month postoperatively and progress to ambulating 25 meters using a walker.

Conclusion: This case highlights the role of MDT in enabling significant weight loss, metabolic improvement, and functional recovery in a patient with super-super obesity. It adds to the limited evidence supporting integrated prehabilitation and surgical strategies in extreme obesity

References: I would like to mention that this abstract was previously submitted at the 15th Emirates Diabetes and Endocrine Congress in Dubai, UAE on February 8th,2025

Disclosure of Interest: None declared