1. 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

2. 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
Diabetes Prevention Program, reported in In this randomized, controlled trial of 1,079 participants aged years, a 58% reduction in incidence of diabetes over 3 years was reported in subjects treated with an intensive lifestyle intervention that included MNT

3. 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

4. Options
Diet & Lifestyle advice (Weight loss & carbohydrate moderation)
Medication (Metformin if no CI)
Both

5. 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
Fasting glucose
159 mg/dL
Triglycerides
121
ALT
50 IU/L
POST WEIGHT LOSS
3 months
98 mg/dL
57 mg/dL
36 IU/L

6. 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

7. 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