Obesity and overweight are considered health risks for non-communicable diseases. Most clinical practice guidelines suggest lifestyle modification as the primary management and as an adjunct to pharmacologic treatment. Using the SMART-EST goaloriented action plan and lifestyle medicine may improve weight reduction outcomes. The case presented had clinical criteria (3/5) for metabolic syndrome, diagnosed previously as obese stage II, asthma moderately uncontrolled, prediabetes, and mild dyslipidemia. Baseline weight and waist-to-hip ratio were taken and interpreted as obese stage II with a very severe risk for comorbidity. The diagnostics used were fasting plasma glucose, lipid profile, HbA1c, and 2-D echocardiography on the eight months of intervention only. Using the SMART-EST action plan plus Lifestyle medicine approaches as non-pharmacologic management for metabolic syndrome. There was an 11.4 % reduction in weight, improved fasting glucose, lipid profile, and 2-D echocardiography within the eight months of intervention.