engleski

From Obesity to Hypothyroidism : approach to an Obese Patient

Obesity is most commonly caused by improper, irregular diet, and physical inactivity. However, sometimes the treatment of obesity is not easy, and other underlying diseases should be suspected. We present a forty-six year old patient who previously had a proper weight, and with stressful situations at work and in the family had increased appetite resulting in significant weight gain. Once divorced, and after her daughter was placed in the care of the father, the patient was depressed and sought help from a psychiatrist who involved antidepressant therapy. Through the patient’s evaluation, with the obesity and increased waist circumference, it was determined the patient also had diabetes mellitus, dyslipidemia, dominant hypercholesterolemia and hypertension. With the results of the evaluation, the patient was diagnosed with metabolic syndrome. The patient’s neat glycemia, lipids and blood pressure suggested her therapy. With an extreme low calorie diet and physical activity the patient was not losing weight. Endocrinological workup determined hormonal treatment for the presence of hypothyroidism, and a substitution therapy was introduced. After three years, she has a proper body weight, waist circumference, lipids and blood pressure. Medications for diabetes have been significantly reduced. Therefore, in obese patients with metabolic syndrome who have hypercholesterolemia, it is necessary to consider thyroid hormones because using substitution therapy also corrected lipid values and often other components of metabolic syndrome.

obesity; hypothyroidism; therapy

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