Management of weight loss in a patient with Prader-Willi syndrome with satietogenics: a case report

Abstract

Objective: To report the evolution and therapeutic approach in a patient with PraderWilli Syndrome (PWS) associated with literature data assessment with a focus on the pharmacological treatment of obesity in patients with this pathology, since there are currently not many studies that contribute or name a strategy with the use of satietogenics. Methods: The present study was elaborated according to the rules of CARE case report. Due to the cognitive impairment present in the syndrome, the patient’s mother was first contacted about the writing of this paper and was given consent through the signing of the Free and Informed Assent Term for this paper. The patient was treated at a hospital-adjacent Nutrology outpatient clinic in 2019. Case Description: YSP, 20 years old, diagnosed with PWS and Grade III obesity (initial BMI of 55.4kg/m², 140kg) attended the Nutrology outpatient clinic of Adriano Jorge Hospital Foundation – FHAJ in 2019 under referral from a third party, and his companion (relative) reporting hyperphagia and poor school performance, initially without a nutrition plan, during follow-up, nutritional guidance and multi-professional care have been initiated. Results: During the follow-up of the years 2019-2021, resulting from the SARS-CoV-2 pandemic in Brazil and the consequent confinement, the patient presented worsening anxiety and hyperphagia, evolving with increased binge eating and discontinuation of physical activities and diet adherence. During the follow-up in the same period, there were 03 returns denoting weight maintenance, later (2021) the use of on-label (Sibutramine), off-label (Fluoxetine), and Metformin medications were associated with the therapeutic regimen for obesity, due to evidence of insulin resistance. Final considerations: The patient evolved with progressive weight loss and better adherence to the food plan and physical activities.