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Abstract: This patient presented to our hypertension department with a self-reported history of significant dizziness and headache for 1 week and a self-measured blood pressure of 175/100 mmHg. After completing various tests, it was clear that the hypertension was caused by overnutrition, and diet+lifestyle intervention was recommended to carry out weight loss treatment for 3 months, after which the weight and body fat indexes decreased and blood pressure, blood glucose, lipids and other indexes returned to normal.
Basic information】Female, 50 years old
Disease Type】Overnutrition, hypertension, joint strain, hyperlipidemia, hyperglycemia
Hospital】Henan Provincial People’s Hospital
Consultation time】May 2019
Treatment plan] Diet control (low-carbohydrate diet) + lifestyle intervention (exercise, work and rest adjustment)
Treatment period】3 months of outpatient treatment, 2 weeks of outpatient follow-up 1 time
Treatment effect】Weight and body fat indexes decreased, blood pressure, blood glucose, blood lipids and other indicators returned to normal
I. Initial consultation
The patient was a 50-year-old woman with a slightly fat body type. She reported that she felt dizziness and headache since 1 week, and her blood pressure was 175/100mmHg, so she came to our hypertension department. The patient understood and referred to our department, and had an enthusiastic attitude towards weight loss, full of expectation.
II. Treatment process
The patient’s case is very common in the weight loss clinic, and a detailed dietary survey was conducted on the patient. The patient reported that he was fatter than his peers since childhood, loved fried food, often overeat, and would not stop until his stomach was full at every meal. The patient now has other health problems besides high blood pressure, such as joint strain, hyperlipidemia, hyperglycemia, etc. After communicating with the patient, he was instructed to undergo body composition testing, and after the testing, the diagnosis was clear: Grade 2 obesity diagnostic reference index: BMI > 34.6 kg/m2; hypertension, hyperglycemia and other underlying diseases; fatigue, easy sleepiness, drowsiness, snoring, degenerative arthritis and other symptoms. Finally, a 3-month weight loss goal of 10-12 kg was negotiated with the patient, and a 3-month weight loss program was developed, which was a low-carbohydrate diet + lifestyle intervention. The patient was given the types and amounts of food available each day, cooking and processing methods, nutritional supplements consumption methods, daily activity and work and rest habits, etc., and was followed up via APP, WeChat and phone.
(First human composition test)
III. Treatment effect
1 week after the patient implemented the weight loss program, besides the weight loss, the family also indicated that the snoring symptom also improved significantly, and the monitored blood pressure also decreased significantly. This change greatly increased the patient’s motivation to persist, and the whole weight loss process was relatively smooth, and the patient kept in touch with the follow-up nutritionist almost every day and came to the hospital for face-to-face consultation and body composition testing every 2 weeks. After 3 months of diet + lifestyle intervention, the weight loss was obvious (the results are shown in the figure below), with 11.8kg weight loss, 10.4kg body fat loss, 13.6cm waist circumference reduction, 48mmHg systolic blood pressure reduction, 27mmHg diastolic blood pressure reduction, in addition to snoring, hyperglycemia, hyperlipidemia were significantly improved, blood pressure, blood sugar, lipid and other indicators gradually returned to normal.
(Body composition test after 3 months)
IV. Notes
We are glad that the snoring, hyperglycemia and hyperlipidemia of the patients have been improved significantly after treatment. In the process of weight loss, many patients are surprised that not only their body shape has improved, but also other health indicators are improving. After the end of weight loss, patients must continue to rational diet + healthy lifestyle, follow-up dietitian follow-up will also periodically continuous follow-up, to avoid the end of weight loss after the patient a relaxed back to the previous diet and lifestyle, eating and drinking, resulting in rapid weight rebound.
V. Personal insight
With the improvement of living standard, there are more and more obese and overweight patients, which also increase the incidence of hypertension, high blood fat, high blood sugar, joint wear and tear, polycystic ovary syndrome and other diseases, if the patients of these diseases are combined with overweight or obesity, it is recommended to reduce weight first, do not directly consider solving through drugs, because these people often have not only one disease, often accompanied by a variety of obesity-related diseases, through drugs can only solve the corresponding diseases. Through drugs can only solve the corresponding disease, but weight loss is likely to solve a variety of obesity-related diseases, the benefits are much higher than drug treatment. The best way to reduce weight is diet + exercise, followed by pure diet intervention. All weight reduction methods (except liposuction) are inseparable from diet control, and it is recommended that we do not blindly diet to reduce weight, but must reduce weight scientifically and reasonably under the guidance of a nutritionist to avoid malnutrition, massive muscle loss, ketoacidosis, and rapid rebound after weight loss. Just like the patient in this case, she has reaped health through a reasonable weight reduction program.