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BMJ Case Rep. 2018 Aug 17;2018. pii: bcr-2018-225643. doi: 10.1136/bcr-2018-225643.

Successful treatment of obesity and insulin resistance via ketogenic diet status post Roux-en-Y.

Author information

1
Chief Operating Officer, Wells World Services, Valencia, California, USA.
2
College of Medicine, University of Science, Arts and Technology, Montserrat, BWI.
3
Department of Family and Community Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA.
4
National Institutes of Health, National Cancer Institute, Bethesda, Maryland, USA.

Abstract

This is a single case of a 65-year-old American woman who presented with substantial weight gain and insulin resistance (IR) post-Roux-en-Y gastric bypass (RYGB) surgery. Before RYGB, she had reached 340 lbs (155 kg) and a body mass index (BMI) of 56.6 kg/m2 The surgery resulted in a 70 lbs (32 kg) weight loss, bringing her BMI, per cent total weight loss (%TWL) and per cent excess weight loss (%EWL) to 44.9 kg/m2, 20.6% and 36.8%, respectively. Unfortunately, her BMI would return to 53.6 kg/m2, nearly her pre-RYGB BMI. It was then she sought the guidance of a primary care physician with expertise in nutrition and medical management of obesity, who placed her on a ketogenic diet. One year later, she had lost 102 lbs (46.4 kg), resulting in a BMI, %TWL and %EWL of 36.6 kg/m2, 31.7%, and 63.1%, respectively, also further resulting in significant improvements of her inflammatory biomarkers. This case presentation will explore current literature, covering the effects of obesity on IR, pre-diabetes and other disease-provoking inflammatory biomarkers.

KEYWORDS:

diabetes; endocrine system; gastrointestinal surgery; metabolic disorders; nutrition and metabolism

PMID:
30121567
DOI:
10.1136/bcr-2018-225643
[Indexed for MEDLINE]

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