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

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.