Obesity is a chronic disease referred to as a world epidemic. Superobesus management is challenging and requires multidisciplinary follow-up. In this case report, the patient had an initial body mass index (BMI) of 110 kg/m² associated with comorbidities such as type 2 diabetes (T2DM). Initial clinical management was performed with changes in lifestyle, through hypocaloric and ketogenic diet, associated with several antiobesity drugs and the introduction of light physical activity. After a total loss of about 140 kg using only clinical measures, the patient's BMI still remained above 40 kg/m², with indication for bariatric surgery. Patient performed Roux-en-Y gastric bypass (RYGB) with greater safety due to previous important weight loss. After the surgery, the patient evolved to the reversion of type T2DM associated with a psychosocial and quality of life improvement.