IntroductionObesity is a complex disease defined as abnormal or excessive fat tissue accumulation that presents a risk to health. 1According to the World Health Organization (WHO), obesity is a latent disease declared as a non-infectious and noncommunicable pandemic.1,2 Indeed, obesity is linked to more deaths worldwide than being underweight, being a risk factor for cardiovascular diseases, diabetes, musculoskeletal disorders, and some cancers.1,2 In particular, obesity is associated with 13 different cancers, among them: breast, endometrial, ovarian, prostate, liver, gallbladder, kidney, and colon and rectum3,4Most frequently, obesity is a primary condition, while differential diagnosis of secondary obesity includes: Hypothyroidism, Hypercortisolism, Hyperinsulinism (type 2 diabetes), Polycystic Ovary Syndrome, and drugs.Obesity stigma refers to social devaluation and denigration due to excess body weight. 5 Several large-scale studies across various countries showed that a high percentage of patients suffered from obesity stigma also from healthcare professionals.6,7 In particular, primary care physicians spend less time during office visits with patients with obesity as they consider them as noncompliant patients. 8 Therefore, experiences of and expectations for poor treatment may cause avoidance of care, mistrust of doctors, and poor adherence among patients with obesity. 8,9 Obesity stigma can reduce the patient’s quality of care, including preventive and screening care, despite the best intentions of healthcare professionals to provide high-quality care. 8–10The patient was sent to a referral center by the primary care provider for surgical evaluation for long-standing severe obesity (BMI 59). This case report is unique because of its clinical relevance to obesity differential diagnosis.