Obesity hypoventilation syndrome (OHS) is a highly underdiagnosed and undertreated condition, especially in developing countries like India. We present a case of a young 26-year-old male with Metabolic syndrome along with severe OSA with OHS, who after weight reduction of 50 kgs over 2 years was practically cured of the same; with no requirement of PAP, insulin and oral medications in follow-up. This case highlights the importance of evaluating obstructive sleep apnea by a phenotypic approach so that appropriate treatment is given.
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