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Case Reports
. 2025 Mar 28;2025(4):rjae816.
doi: 10.1093/jscr/rjae816. eCollection 2025 Apr.

Very-low-calorie-diet, tirzepatide, and bariatric surgery: a multidisciplinary success in super-super obesity

Carla Daou  1 , Juan S Barajas-Gamboa  1 , Cynthia Salloum  2 , Alfredo Daniel Guerron  1
Affiliations
Case Reports

Very-low-calorie-diet, tirzepatide, and bariatric surgery: a multidisciplinary success in super-super obesity

Carla Daou et al. J Surg Case Rep. .

Abstract

This case report highlights the multidisciplinary team (MDT) approach in managing a 49-year-old male with super-super obesity (initial Body Mass Index (BMI): 106.25 kg/m2). Interventions included very-low-calorie-diet, tirzepatide treatment, and eventual sleeve gastrectomy. Pre-operatively, the MDT focused on optimizing the patient's metabolic status and surgical readiness. The patient, initially bedbound with comorbidities including type 2 diabetes and obstructive sleep apnea, achieved significant weight loss pre-surgery. Post-operatively, the patient followed bariatric diet phases and engaged in physical therapy, improving mobility from bedbound to walking 25 minutes with a walker. Over 1 year, the patient achieved 37% excess weight loss, reducing BMI to 66.79 kg/m2. This case demonstrates the effectiveness of an MDT approach in treating super-super obesity, leading to substantial weight loss and improved health outcomes.

Keywords: bariatric surgery; medications; multidisciplinary team; nutrition; super-super obesity.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Weight trend since admission until October 2024, pre and post-op.
Figure 2
Figure 2
BMI trend since admission until October 2024, pre and post-op.
Figure 3
Figure 3
Time line reflecting treatment care for throughout admission.
See this image and copyright information in PMC

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