May 14, 2019

Case Study: Moises, 32

Overview

In 2014, Moises was diagnosed with type 2 diabetes, high blood pressure and high cholesterol. He enrolled in Better in August 2017 to address these cardiometabolic diseases.

Medications
  • Metformin 500mg, 3x per day (diabetes)

  • Simvastatin 20mg, 1x per day (high cholesterol)

  • Lisinopril 20mg, 1x per day (high blood pressure)

Other Health Conditions & Concerns
  • Class 2 obesity

  • Obstructive sleep apnea treated by using a continuous positive airway pressure (CPAP) machine throughout the night

  • Regular headaches and fatigue

  • Poor quality of life due to his poor overall health

Family History

Moises’ father struggled with type 2 diabetes and eventually died from complications of the disease. Watching his father suffer and die from diabetes was a strong motivator for Moises. He wanted to avoid these complications and spare his family from another tragic loss.

Behavioral Treatment

Challenges & Concerns
  • Moises was fearful that his efforts to sustain behavior changes would fail. He tried many times in the past but always reverted back to his old ways and regained weight.

  • He was skeptical about his ability to reduce meat and dairy, since these were his staple foods.

  • He experienced significant pressure from friends and family about eating differently from them. According to Moises, “they helped create the problem, but they won't help me solve it.”

  • Moises had a demanding work schedule - juggling two jobs - with little time to exercise.

Behavior Changes
  • With guidance from Better, Moises made a commitment to identify and address the thoughts and beliefs that were keeping him from forming healthier habits.

  • He realized that he needed to gain skills and a new mindset around preparing food. He used the app to guide meal planning, grocery shopping, prepping and storing food each week.

  • To make meal prep convenient and affordable, and therefore sustainable, he bought in bulk at Costco.

  • With the help of his coach, Moises was able to put his motivation into action and changed from eating a lot of meat, cheese, and pizza, to eating mostly whole plant foods.

  • Moises used Better’s app about 4 times each day to track blood sugar and weight, and use the skill-building tools. This helped him understand the impact of his behavioral changes on his condition.

  • Moises also learned to find creative ways to fit exercise into his busy schedule. For example, he used resistance bands in the work breakroom to fit activity in during the day. He was able to increase physical activity from 2 days/week to 6 days/week.

“I feel like I could take this experience and apply it to other areas of my life. It's been hard, there’s been failure, but it is doable. I want a long healthy life - I know that this right here is the key. I want to be an example to myself and others.”

Results

  • Within three months, Moises’ blood sugar, blood pressure and cholesterol were all within normal ranges and he was taken off of all medications.

  • His sleep apnea improved to the point where he no longer needed a CPAP device.

  • Moises has more energy and is able to think more clearly.

  • He gained confidence in his ability to take on challenges, not just with his health, but also other areas of his life.

Moises A1c
Moises-Cholesterol
Weight

“I have so much more energy and I am happy. I feel like I look happy.”

Takeaways

  • Moises’ case shows the impact of comprehensive behavioral changes on diabetes, high blood pressure and high cholesterol.

  • He experienced measurable changes within the first two weeks and a return to normal values in three months.

  • Moises was able to leverage his innate strengths and motivation, gain skills needed to make behavioral changes sustainable, and find meaning and value in his efforts to improve his health.

  • Nearly two years later, behavior changes have persisted and Moises continues to see improvements in his health and quality of life.