A CASE FROM
WEIGHT LOSS
CLINIC
Dr Peter Goulden MD, FRCP, PGCE
Assistant Professor
& Diabetes Program Director
Division of Endocrinology & Metabolism
UAMS College of Medicine
A CASE FROM THE WEIGHT LOSS CLINIC
 45 year old male.
 Referred himself to the weight loss clinic as had been getting back pain and
had been investigated and had been told weight loss would help
 No significant Past Medical History but had not attended doctor for some
time
 BMI 45.6 kg/m2
 Had been on a weekend “food trip” ahead of entering the program
A CASE FROM THE WEIGHT LOSS CLINIC
 Fasting lab glucose of 153 mg/dL
 Fasting triglycerides = 121 mg/dL
 Alanine Aminotransferase = 50 IU/L
 Would prefer to avoid medication
OPTIONS
1.
Diet & Lifestyle advice (Weight loss & carbohydrate moderation)
2.
Medication (Metformin if no CI)
3.
Both
WHAT WE DID
 Enrolled to a 1200kcal diet
 Achieved 26.9 pounds weight loss in 12 weeks with close medical
supervision
LAB
PRE WEIGHT
LOSS
POST WEIGHT LOSS
3 months
Fasting glucose
159 mg/dL
98 mg/dL
Triglycerides
121
57 mg/dL
ALT
50 IU/L
36 IU/L
UAMS WEIGHT LOSS PROGRAM
 16 week program & bespoke diet – daily restriction from 400kcal+
 Endocrinologist led and obesity educator delivered
 Caloric restriction tailored to individual
 Carbohydrate moderation
 Weekly review with nutritionist
 1-2 monthly review with MD depending on case
QUESTION FOR DISCUSSION
 Patient centered decision making key
 Weight loss and carbohydrate awareness may have a
profound impact
 Counseling has to be tailored to the individual
 How can weight loss programs be best delivered to the
population allowing for variance in health literacy and
other factors