Holistic Care Approach Helps Patients With Severe Obesity

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A multidisciplinary, personalized weight loss plan including semaglutide, dietary counseling, and physical therapy helped a patient with severe obesity.

A multidisciplinary approach incorporating pharmacologic treatment, dietary counseling, and physical rehabilitation can be highly effective for improving outcomes among patients with severe obesity, according to research presented at the AACE Annual Meeting 2025.¹

A Case of Severe Obesity

Researchers from Kolkata presented a case in which a 48-year-old Hispanic female patient with a BMI of 44 kg/m² achieved weight loss after receiving personalized treatment at an obesity clinic. The patient had several comorbidities and reported that past weight loss attempts were unsuccessful.

Clinicians designed a care plan including semaglutide therapy, comprehensive dietary counseling that emphasized caloric restriction and macronutrient balance, and physical therapy geared toward the patient’s mobility challenges.

After 6 months of treatment, the patient saw improved BMI and cardiometabolic outcomes, as well as improvements in pain and mobility.

“Combining GLP-1 receptor agonist therapy with tailored dietary and physical rehabilitation interventions resulted in significant clinical and functional outcomes,” said Rishad Ahmed, MD, MBBS, and colleagues. “Key challenges included adherence to dietary recommendations and initial resistance to physical activity, which were mitigated through continuous engagement and motivational strategies. This case underscores the importance of individualized, holistic care in obesity management.”

Possible Components of a Multidisciplinary Approach

Recent guidelines and clinical research emphasize that coordinated care across medical, behavioral, nutritional, and surgical specialties leads to better outcomes in weight loss, comorbidity management, and long-term adherence.

Multidisciplinary obesity care may include the following components:

Medical Evaluation and Coordination: Physicians, particularly those trained in obesity medicine or endocrinology, play a central role in assessing obesity-related complications (eg, hypertension, sleep apnea) and ruling out secondary causes. They also coordinate referrals to other specialists and guide pharmacologic or surgical interventions.²

Nutrition Therapy: Registered dietitians can provide individualized dietary interventions, typically recommending a daily caloric intake of 1,200–1,500 kcal for women and 1,500–1,800 kcal for men. Patients may try very low-calorie diets (<800 kcal/day) under medical supervision. Dietitians also educate patients on sustainable eating patterns and nutritional adequacy.³

Physical Activity Prescription: Exercise physiologists can assess patients’ functional capacity and prescribe tailored physical activity regimens. While exercise alone leads to modest weight loss (1–3%), studies have shown that it is crucial for maintaining weight loss and improving metabolic health. Programs often include at least 150 minutes/week of moderate-intensity aerobic activity and resistance training 2–3 times/week.⁴

Behavioral and Psychological Support: Behavioral therapy, including cognitive-behavioral therapy, can help patients address maladaptive eating behaviors, emotional regulation, and motivation. Psychologists or behavioral therapists help patients develop coping strategies, manage stress, and prevent relapse. Studies have shown that incorporating psychological support into obesity treatment enhances adherence and outcomes.⁵

Pharmacotherapy: Physicians may consider prescribing obesity medications for patients who cannot sufficiently achieve weight loss with lifestyle interventions alone. FDA-approved medications include semaglutide, tirzepatide, liraglutide, phentermine, phentermine-topiramate, bupropion-naltrexone, setmelanotide and orlistat.

Bariatric Surgery: For patients with severe obesity unresponsive to medical therapy, bariatric surgery can offer significant and sustained weight loss. Procedures such as sleeve gastrectomy and Roux-en-Y gastric bypass are effective but require thorough preoperative evaluation and lifelong postoperative follow-up to monitor for nutritional deficiencies and other complications.⁵