Ex-Sumo Wrestler Loses 40 kg on Dulaglutide: A Case Study in Challenging Obesity Treatment

What the researchers found

The patient achieved a 40 kg weight loss (21% of body weight) and a BMI reduction from 49.66 to approximately 39.4 kg/m² over 6 months of dulaglutide treatment. This occurred despite multiple factors working against weight loss:

• Multiple antipsychotic medications for bipolar II disorder (known to cause weight gain)

• Non-compliance with lifestyle modifications

• Resistance to conventional treatment with metformin

• History as a professional sumo wrestler (extreme prior weight conditioning)

No side effects were reported, and glycemic control improved alongside the weight loss.

Why it matters

This case demonstrates that GLP-1 agonists can work even in patients where everything seems stacked against success — extreme obesity, psychiatric medications that promote weight gain, and poor adherence to lifestyle changes. It highlights dulaglutide's potential in 'treatment-resistant' obesity cases and supports considering GLP-1 therapy for patients on antipsychotic medications, a population at particularly high risk for metabolic complications.

How the study worked

Single patient case report documenting the clinical course of a 27-year-old male former sumo wrestler treated with dulaglutide for morbid obesity with multiple comorbidities. Weight, BMI, and glycemic parameters were tracked over 6 months of treatment.

What this study cannot tell us

This is a single case report with no control group or blinding. Case reports represent the lowest level of clinical evidence. The dramatic result in one patient cannot be generalized to broader populations. Specific dulaglutide dosing is not detailed in the abstract. The 6-month follow-up is relatively short — long-term weight maintenance is unknown. The interaction between dulaglutide and multiple antipsychotic medications was not systematically characterized.

How to read the evidence

This is a single case report — the lowest level of clinical evidence. While the result is dramatic and well-documented, it represents one patient's experience and cannot establish efficacy or safety for similar patients. Case reports are valuable for generating hypotheses and documenting unusual outcomes but do not replace controlled studies.

When this study was published

Published in 2024, this case report is recent and reflects current prescribing of dulaglutide for obesity. The growing use of GLP-1 agonists in psychiatric populations makes this timely despite its limited evidence level.

The bigger picture

Antipsychotic-induced weight gain is a major clinical problem affecting millions of psychiatric patients worldwide. GLP-1 agonists are increasingly being studied for this population. This case report, while just one patient, adds to the growing evidence that peptide-based obesity drugs may be particularly valuable for patients whose weight gain is driven by psychiatric medications — a group that has historically had few effective options.

Questions still open

• Can dulaglutide or other GLP-1 agonists reliably counteract antipsychotic-induced weight gain in larger patient populations?
• Will this patient maintain the 40 kg weight loss long-term, or will weight regain occur as seen with many obesity treatments?
• Are there drug interactions between dulaglutide and antipsychotic medications that should be monitored?

Common questions

Read the original research

Transformative weight loss with Dulaglutide: A case report of success in a challenging patient profile of an ex-sumo wrestler.

Clinical case reports, 12(9), e9403

Citation

Bade, Sohail; Bade, Sahil; Sharma, Grishma; Bhurtel, Narayan; Singh, Yadvinder; Paudel, Sudip; Magar, Frena Pulami; Chapagain, Kshitij. (2024). Transformative weight loss with Dulaglutide: A case report of success in a challenging patient profile of an ex-sumo wrestler.. Clinical case reports, 12(9), e9403. https://doi.org/10.1002/ccr3.9403