Massive weight loss without surgery in a super obese patient

Large weight losses are rarely achieved through non-surgical procedures, but are also possible without professional help. A massive weight loss may be complicated by the development of an eating disorder psychopathology, followed by weight regain. We report the case of a male patient with super obesity (BMI, 86.2 kg/m2), who achieved a massive weight loss (170 kg in two years) largely without professional help and without surgery. The final body weight (~100 kg, BMI 32.6) has now been maintained for nearly 2 years. After weight loss, the patient had massive skin redundancy in several areas including the breasts, arms, abdomen, back and thighs and a true body weight probably in the normal range. All laboratory tests were normal, with the exception of low free testosterone. Sonographic examination showed gall bladder microlithiasis. No eating disorders and other axis I and axis II psychiatric disorders were present. The case illustrates how much weight loss and weight loss maintenance can be exceptionally achieved without surgery and without developing an eating disorder of clinical severity or other psychiatric disorders.