Medical weight loss & lifestyle changes lead to dramatic health improvement in 45 year old male

J.K. is a 45 year old man who presented to Dr. Avi Ishaaya at the Aviisha Medical Wellness Institute in 2008. At his first appointment J.K. weighed 330 lbs and was 5’8. The patient complained of lack of energy, loud snoring, and feeling very tired during the day. He noted that he cannot stay awake through a movie without falling asleep. Recently, he fell asleep at a stoplight, and only woke up when the car behind him honked his horn.

 

The patient was recently diagnosed with diabetes and takes medication to manage his blood sugar. Even so, his blood sugar remains high at a count over 200. J.K.’s blood pressure is uncontrolled. He notes that the blood pressure medications make him dizzy and at time impotent. His joints, most notably his knees, ache when walking. He has leg swelling and discoloration of his legs. Also noteworthy, he has severe heartburn which is worse in the lying position.

 

On examination, J.K.’s neck size is 18 inches and waist size is 45 inches. He has enlarged breasts and an enlarged liver edge. His legs are swollen. Blood pressure is elevated at 150/100 and oxygen level is 92%. His  pulse is 110 and breathing rate is 22. He has multiple skin tags and dark discoloration of his legs.

 

Laboratory data reveals a blood sugar of 240 and a total cholesterol of 250. A heart ultrasound performed demonstrated that the ejection fraction of the heart was reduced at 40% (normal usually greater than 60%). Percent body fat was 48%. Sleep study showed that he had severe sleep apnea and stopped breathing 50 times per hour, with his oxygen level dropping to 75%.

 

The patient’s typical diet includes 3-5 sodas per day, 3 cheeseburgers, and 2 extra large French fries. He snacks on chips, cookies, and rarely will eat any raw vegetables. He rarely gets out of the house and works from home. He has only a few friends and finds himself embarrassed to be out in public.

 

After a thorough evaluation by the Aviisha medical staff, the patient was placed on an 800 calorie per day, medically supervised diet. The medical supervision includes close follow up with weekly visits, monthly medical visits, and nutritional counseling. The patient maintained a food log, logging in all food eaten on a daily basis. Dr. Ishaaya, the Aviisha dietician, and the Aviisha medical staff defined a customized plan for J.K. including meal replacements, vitamin supplements, appropriate appetite suppressants, and Lipo injections. J.K. also began an exercise program prescribed by the Aviisha staff.

 

 

1^st                    300                  200                              140/92

2^nd                    280                  180                              140/88

3^rd                    260                  170                              138/85

6^th                    205                  110                              130/82

9^th                    170                  100                              120/82

12^th                  165                  90                                110/80

 

After one year of care under the Aviisha Medical Wellness Institute, J.K. is now off all medications. A repeat sleep study was performed and is now normal. All obstructive sleep events are resolved and he no longer snores. Blood sugars and blood pressure are at normal levels, without medications. The patient is now very active, with daily jogs, weekend biking and hiking. He continues to see the Aviisha staff every 2 months to weigh in.

 

His heart ultrasound now reveals that his ejection fraction is near normal and his body fat is at 20%.