Lifestyle Modification Through Lifestyle Medicine to Control and Reduce Complications in Patients with Hypertension and Obesity.

Abstract

     This case describes a 48-year-old Thai woman, married, with an 8-year history of hypertension and poor medication adherence, presenting with recurrent dizziness and fatigue. Her blood pressure was 180/110 mmHg and BMI 30.46 kg/m² (obese). She reported unhealthy behaviors including frequent sticky rice and salty food intake, low fruit and vegetable consumption, stress-related wine drinking, and minimal exercise. She previously lost weight with medication but regained it after discontinuation. Over the past month, she recognized her health problems and began walking 30 minutes/day, 5 days/week with friends, but symptoms persisted. She was assessed in the Action stage of change. Motivational interviewing and family support were used to enhance adherence, prevent relapse, and encourage regular medication use.

     The treatment plan applied the six pillars of Lifestyle Medicine, emphasizing the DASH diet with reduced sodium (<2,300 mg/day), ≥4 servings of vegetables/day, limited sticky rice and processed foods, ≥150 minutes/week of brisk walking and resistance training, reduced alcohol intake, stress management, adequate sleep, and healthy social connections. Follow-up was scheduled every 2–4 weeks to monitor blood pressure, BMI, and body composition. Goals, motivation, and barriers were reviewed regularly to maintain target blood pressure and lower the risk of complications.