Posters
Presentation Type
Poster
Discipline Track
Patient Care
Abstract Type
Case Report
Abstract
Introduction: The prevalence of obesity has reached epidemic proportions worldwide, presenting a significant challenge to public health systems and clinicians alike. The CDC published new statistics for the prevalence of obesity in the United States, with numbers reaching 41.9% from 2017-2020. Morbid obesity, indicated by a body mass index (BMI) of 40 kg/m² or higher, is associated with an increased risk of numerous comorbidities, including cardiovascular disease, type 2 diabetes, hypertension, and musculoskeletal disorders. This case report aims to explore the available treatment options for a Hispanic female with Obesity Class III and multiple comorbidities while keeping insurance coverage and population health in mind.
Case Presentation: Our patient is a 63 y/o Hispanic female with multiple comorbidities, including Obesity Class III, Heart Failure with Reduced Ejection Fraction, pacemaker placement, stage 5 chronic kidney disease (CKD) on hemodialysis, and type 2 diabetes mellitus. Patient presented to clinic for hospital follow-up after being started on dialysis for treatment of hyperkalemia. Patient is 5ft 2in and weighs 276 lbs. Current BMI is 50.5 kg/m2. Patient's weight remains largely uncontrolled despite lifestyle modifications. Potential interventions at this time present a myriad of problems and risks.
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Drug Therapy: GLP-1 receptor agonists were recommended but have not been approved for coverage by insurance yet. Patient is unable to pay out of pocket for treatment. Orlistat therapy poses the potential risk of ESRD exacerbation due to oxalate nephropathy.
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Bariatric Surgery: Our patient could benefit from bariatric procedures. However, due to comorbidities, our patient is at significantly higher risk of post-surgical complications, according to ACS NSQIP Surgical Risk Calculator.
Discussion: This patient’s case highlights the challenges of obesity treatment, revealing a complex interplay between obesity and its associated comorbidities. There is a vicious cycle in the pathology of obesity in which complications arising from obesity further hinder the treatment options available. Furthermore, our patients case underscores the alarming prevalence of obesity in the U.S. Hispanic population, with a prevalence of 45.6%, according to the CDC. This case serves as a compelling reminder of the necessity to expand obesity care to ensure early interventions. With proactive treatment of obesity before extensive complications take hold, clinicians can mitigate the burden of obesity on both the patient and the public health system overall.
Academic/Professional Position
Medical Student
Academic/Professional Position (Other)
MS3
Recommended Citation
Arab, Shuaibahmed M.; Althaus, Elizabeth; Campos, Pamela; Selva, Sidney; Bialaszewski, Ryan; and Chang, Chelsea, "Exploration of Treatment Options for a Hispanic Patient with Obesity Class III and Multiple Comorbidities" (2024). Research Symposium. 41.
https://scholarworks.utrgv.edu/somrs/2023/posters/41
Included in
Exploration of Treatment Options for a Hispanic Patient with Obesity Class III and Multiple Comorbidities
Introduction: The prevalence of obesity has reached epidemic proportions worldwide, presenting a significant challenge to public health systems and clinicians alike. The CDC published new statistics for the prevalence of obesity in the United States, with numbers reaching 41.9% from 2017-2020. Morbid obesity, indicated by a body mass index (BMI) of 40 kg/m² or higher, is associated with an increased risk of numerous comorbidities, including cardiovascular disease, type 2 diabetes, hypertension, and musculoskeletal disorders. This case report aims to explore the available treatment options for a Hispanic female with Obesity Class III and multiple comorbidities while keeping insurance coverage and population health in mind.
Case Presentation: Our patient is a 63 y/o Hispanic female with multiple comorbidities, including Obesity Class III, Heart Failure with Reduced Ejection Fraction, pacemaker placement, stage 5 chronic kidney disease (CKD) on hemodialysis, and type 2 diabetes mellitus. Patient presented to clinic for hospital follow-up after being started on dialysis for treatment of hyperkalemia. Patient is 5ft 2in and weighs 276 lbs. Current BMI is 50.5 kg/m2. Patient's weight remains largely uncontrolled despite lifestyle modifications. Potential interventions at this time present a myriad of problems and risks.
-
Drug Therapy: GLP-1 receptor agonists were recommended but have not been approved for coverage by insurance yet. Patient is unable to pay out of pocket for treatment. Orlistat therapy poses the potential risk of ESRD exacerbation due to oxalate nephropathy.
-
Bariatric Surgery: Our patient could benefit from bariatric procedures. However, due to comorbidities, our patient is at significantly higher risk of post-surgical complications, according to ACS NSQIP Surgical Risk Calculator.
Discussion: This patient’s case highlights the challenges of obesity treatment, revealing a complex interplay between obesity and its associated comorbidities. There is a vicious cycle in the pathology of obesity in which complications arising from obesity further hinder the treatment options available. Furthermore, our patients case underscores the alarming prevalence of obesity in the U.S. Hispanic population, with a prevalence of 45.6%, according to the CDC. This case serves as a compelling reminder of the necessity to expand obesity care to ensure early interventions. With proactive treatment of obesity before extensive complications take hold, clinicians can mitigate the burden of obesity on both the patient and the public health system overall.