Module 11: Energy Balance Case Study
Mr. Zepbound (55 y/o male) recently joined UIHealth’s bariatric surgery program and is
pursuing weight loss surgery.
He has a history of diet and exercise, however, has not been able
to maintain weight loss long-term.
In addition to weight loss, he has type 2 diabetes mellitus,
hyperlipidemia, hypertension, and obstructive sleep apnea. Currently, Mr. Zepbound weighs 315
lbs and is 5’9” tall.
Past Medical History:
Class III Obesity
History of long-term obesity
Type 2 diabetes treated with Metformin (OHA) and Lantus (insulin)
Hyperlipidemia treated with Lovastatin
Hypertension treated with Lasix
Obstructive Sleep Apnea (CPAP compliant)
Osteoarthritis s/p R total knee replacement.
Non-smoker
Vitals:
BP 138/90
Height 5’9’’ (1.75 m)
Weight 315 lbs. (143 kg)
Laboratory (fasting):
Glucose: 145 mg/dl; reference 70-99 mg/dl
Cholesterol: 320 mg/dl; reference < 200 mg/dl
HDL-C: 32 mg/dl; reference > 50 mg/dl (male)
LDL-C: 232 mg/dl; reference < 130 mg/dl
HbA1c: 7.2 %; reference < 5.7%
CRP: 4.0 mg/dl, > 1 increased cardiovascular risk
Hemoglobin: 11.5 g/dl; reference 12-16 g/dL (female)
Alanine transaminase (ALT): 38 U/L; reference 4-36 U/L
24-hour dietary recall (Sunday), Wake up: 7.45 am
Breakfast: 8am
Boost Glucose Control
AM Snack:
none
Lunch: Noon: Bacon + eggs + 1/2x French toast
PM Snack:
none
Dinner: 8pm
1x baked chicken leg and string beans
