Since 2006 at our hospital, lifestyle modification, such as diet and exercise, for obese patients has been provided through a team approach with a physician, dietician, physical therapist and psychologist. From 2016, a surgeon, anesthesiologist and nurse were added to the team for metabolic/bariatric surgery. The aims of this study are to clarify the effectiveness and problems of lifestyle modification, and to clarify the characteristics of patients who transferred for surgical treatment. The diet menu is as follows: intake energy is (resting energy expenditure + exercise energy) × 0.9, and nutrients/total energy is 5560% carbohydrates, 1520% protein and 2025% fat. The exercise is performed as follows: regular exercise more than 3 times per week or more than 5000 steps per day, and if possible, more than 10000 steps per day. Until now, 150 obese patients (mean age of 50 years and mean body mass index (BMI) of 31) have received medical management, and the mean BMI significantly decreased by 1.2 over 3 months. Twenty patients (13%) have transferred for surgical treatment. Ten patients have diabetes with a BMI of 3147 and HbA1c 89% despite intensive insulin therapy. Four with a BMI of 4160 have bilateral knee osteoarthritis and require total knee replacement, and two with a BMI of 3651 have severe sleep apnea. Diabetic patients need a lower BMI for metabolic/bariatric surgery compared with non-diabetic patients.
18 - 21 May 2019
European Society of Endocrinology