Patient profile: Male, 52 years old, BMI 30 kg/m2.

Presentation: The patient was overweight, had central adiposity, a family history of diabetes, a history of yo-yo dieting and wanted a more sustainable way to improve his health.

Assessment: The assessment included metabolic bloods, body composition, dietary history, sleep, stress and readiness for change.

Clinical picture: The main issue was long-term cardiometabolic risk linked to excess weight and repeated unsuccessful weight loss attempts.

Support plan: The plan focused on long-term sustainability rather than quick results. Nutrition was based on Mediterranean principles with flexible carbohydrate control and a calorie target to support gradual weight loss of 0.5 to 1% of body weight each week. Behavioural work included SMART goals, food environment changes and relapse prevention. Exercise built up gradually towards 300 minutes per week of combined aerobic and resistance activity. Metabolic optimisation included vitamin D, thyroid review, and addressing sleep and stress. Short-term nutraceutical support for appetite was considered only if safe. Follow-up was every fortnight for the first 3 months, then monthly.

Outcome at 6 months: The patient achieved sustained weight loss of 8%. Waist circumference, fasting glucose and LDL improved. He also reported better energy, better sleep and stronger adherence to his new habits.

Key point: Steady, realistic change with regular support is often more effective than strict short-term dieting.