Naturopathic Management of Obesity and Metabolic Dysfunction in a 74-Year-Old Female: A Case Study

Shri Sivalaya Holistic Natural Healing Hospital

Abstract

Obesity in older adults is frequently associated with cardiovascular and metabolic comorbidities and requires comprehensive clinical assessment. This case describes a 74-year-old female who presented with increased body weight and was evaluated for associated metabolic abnormalities. She was found to have Class III obesity, hypertension, dyslipidemia, coronary artery disease, impaired glycemic regulation and mild anemia. She also had a history of bilateral total knee replacement. Baseline investigations revealed HbA1c of 6.1%, TSH of 2.77 µIU/mL, vitamin D of 52.29 ng/mL and vitamin B12 of 672 pg/mL. During the documented period, her body weight reduced from 84.6 kg to 82.8 kg, with a net reduction of 1.8 kg.

Keywords: Obesity, metabolic health, elderly, hypertension, dyslipidemia, coronary artery disease, impaired glucose regulation, vitamin D, vitamin B12.

Introduction

Obesity is an important metabolic health concern and is commonly associated with hypertension, dyslipidemia, impaired glucose regulation and cardiovascular disease. In older adults, comprehensive assessment is particularly important because metabolic abnormalities may coexist with reduced physical capacity and multiple chronic conditions. This case presents the clinical assessment and short-term outcome of a 74-year-old female with Class III obesity and associated metabolic and cardiovascular conditions.

Case Presentation

A 74-year-old female presented with the chief complaint of increased body weight. At the time of assessment, her height was 143 cm and body weight was 84.6 kg, corresponding to a BMI of approximately 41.4 kg/m², consistent with Class III obesity. Her recorded vital parameters were a pulse rate of 67/min, blood pressure of 111/74 mmHg, and oxygen saturation of 98%. She was afebrile.

Relevant Medical History

The patient had a history of: Hypertension Dyslipidemia Coronary artery disease Impaired glucose regulation Mild anemia Bilateral total knee replacement in 2017 Previous sebaceous cyst surgery She was receiving conventional medical management for her existing medical conditions.

Physical Examination

On general examination, the patient was obese and adequately nourished and hydrated. No significant pallor, icterus, cyanosis, clubbing or lymphadenopathy was documented.

Systemic examination revealed no significant abnormality in the respiratory system. Cardiovascular examination revealed S1 and S2 without significant documented abnormality. No organomegaly was noted on abdominal examination, and no focal neurological deficit was documented.

Laboratory Investigations

The patient's investigations showed a hemoglobin level of 11.3 g/dL, suggestive of mild anemia. Fasting blood glucose was 100 mg/dL, postprandial blood glucose was 117 mg/dL, and HbA1c was 6.1%, indicating impaired glycemic regulation. Renal parameters were within the documented range, with serum urea 27 mg/dL and serum creatinine 0.86 mg/dL. Serum uric acid was 5.6 mg/dL. Thyroid function assessment showed a TSH value of 2.77 µIU/mL. Vitamin D level was 52.29 ng/mL, while vitamin B12 was 672 pg/mL.

Provisional Diagnosis

Based on the clinical assessment and available investigations, the provisional diagnoses were: Class III obesity Hypertension Dyslipidemia Coronary artery disease Impaired glucose regulation Mild anemia

Clinical Outcome

The patient's body weight was monitored during the period of hospitalization. Her initial weight was 84.6 kg, and by the end of the documented period, her weight was 82.8 kg, showing a net reduction of 1.8 kg. Minor fluctuations in daily weight were observed during the period, but the overall trend demonstrated a reduction in body weight. Her recorded blood pressure remained within the documented range, with no significant acute deterioration noted.

Discussion

This case demonstrates the importance of comprehensive metabolic assessment in an elderly patient with severe obesity and multiple cardiovascular risk factors. The coexistence of hypertension, dyslipidemia and coronary artery disease increases the patient's overall cardiometabolic risk and warrants continued monitoring. The patient's HbA1c of 6.1% indicates impaired glycemic regulation and highlights the importance of monitoring glucose metabolism. The TSH level of 2.77 µIU/mL was within the usual reference range and did not indicate an overt thyroid abnormality based on this value alone. The recorded vitamin D level of 52.29 ng/mL and vitamin B12 level of 672 pg/mL indicate measurable circulating levels of both nutrients. Hemoglobin of 11.3 g/dL was consistent with mild anemia and warrants appropriate clinical follow-up. Despite minor day-to-day variations, the overall reduction in body weight from 84.6 kg to 82.8 kg represents a favourable short-term change. Long-term follow-up would be necessary to determine whether the weight reduction is sustained and whether further improvements occur in glycemic, lipid and cardiovascular parameters.

Conclusion

This case highlights the importance of comprehensive evaluation of weight status, glycemic control, cardiovascular risk, thyroid function, renal function, vitamin status and hematological parameters in elderly patients with obesity. The patient presented with Class III obesity and multiple associated metabolic and cardiovascular conditions. Her investigations showed HbA1c of 6.1%, TSH of 2.77 µIU/mL, vitamin D of 52.29 ng/mL, vitamin B12 of 672 pg/mL, and hemoglobin of 11.3 g/dL.

During the documented period, her body weight decreased from 84.6 kg to 82.8 kg, with a net reduction of 1.8 kg, demonstrating a positive short-term weight trend. Continued clinical monitoring and long-term follow-up are recommended to evaluate sustained metabolic improvement.