CLINICAL OUTCOMES OF A MULTIMODAL APPROACH COMBINING LOW-CARBOHYDRATE DIET AND PHARMACOTHERAPY FOR OBESITY MANAGEMENT

Abstract

INTRODUCTION
Obesity and metabolic syndrome increase the risk of cardiovascular disease and type 2 diabetes. Effective weight management strategies are essential, including dietary modifications and pharmacologic interventions. This study evaluates the impact of a structured low-carbohydrate diet combined with pharmacologic therapy on metabolic parameters in patients attending the Low-Carb Clinic at Hospital Al-Sultan Abdullah, Universiti Teknologi MARA (UiTM), Puncak Alam.

METHODOLOGY
Forty-six participants (mean age 50 years, BMI 43.68 kg/m²) attended the clinic for 11.6 months. The intervention involved a low-carbohydrate diet (less than 130 g/day). Pharmacologic treatments included GLP-1 receptor agonists (Ozempic, Saxenda, Rybelsus, Trulicity) and weight loss agents (Duromine, Orlistat) in selected cases. Key assessments included anthropometric indices, glycaemic control, lipid and renal profiles, liver function tests, and blood pressure.

RESULT
The participants’ mean age was 50 ± 12 years. 56.5% were female. Thirty-nine patients received GLP-1 receptor agonists; while twelve of them received other weight loss agents (Duromine and Orlistat), and two underwent bariatric surgery. Post-intervention, participants showed significant weight loss (mean −6.49 kg, p <0.01) and BMI reduction (−2.47 kg/m², p <0.01). Central adiposity decreased, including waist (−5.5 cm, p <0.01) and neck circumference (−1.8 cm, p <0.01). HbA1c dropped by 0.35% (p = 0.05). ALT decreased (−6.41 mmol/L, p = 0.011), indicating improved liver function. LDL increased by 0.36 mmol/L (p = 0.04), possibly due to increased fat intake. Fasting glucose, triglycerides, and blood pressure remained unchanged.

CONCLUSION
A low-carbohydrate diet combined with pharmacologic therapy, particularly GLP-1 receptor agonists, significantly improved weight, glycaemic control, and liver function. These findings support combining dietary and pharmacologic strategies for sustainable obesity management.