Endocrine Abstracts

Obesity hypoventilation syndrome (OHS) occurs in the setting of excessive weight gain and is characterized by chronic hypercapnia. Most subjects have associated obstructive sleep apnea and daytime somnolence. It’s a condition which is amenable to weight loss in the range of 25-30 % of body weight. 67-year-old lady presented to the endocrine clinic 8 months ago, with a longstanding history of obesity, hypertension, type 2 diabetes mellitus, hypertensive heart disease, low-back pain, bilateral knee osteoarthritis and left shoulder arthritis. She was followed up in the last five years by the cardiologist for hypertensive heart disease and recurrent heart failure. Also, by the pulmonologist for chronic obstructive airway disease and OHS: was on domiciliary oxygen therapy, in addition to a CPAP device. She was admitted for respiratory failure at the intensive care unit in March 2025. Findings at presentation include: respiratory distress, difficulties walking and a BMI of 49.1 kg/m2. Her FBS was 140 mg/dl and HbA1c was 7.5%. On a subsequent follow up visit a month later, her respiratory symptoms and signs predominate, and was counselled on the need for weight loss. She was started on S/C Ozempic 0.25 mg weekly for four weeks; and increased to 0.5 mg weekly for another four weeks. Ozempic was thereafter continued at 1 mg weekly. After 2 months on Ozempic, she lost 7 kg with improvement in respiratory symptoms. At 4 months, she lost a total of 9 kg. And lost a total of 22.5 kg at 6 months. Her current BMI is 39.5 kg/m2, with resolution of respiratory distress and obstructive sleep apnea. She now sleeps well at night without a CPAP machine and no longer needs domiciliary oxygen. Weight loss is the definitive treatment for obesity hypoventilation syndrome. GLP-1RAs, such as semaglutide, is a useful therapeutic option for treatment.