A male patient aged 42 weighing 145 kg and height 5 feet 3 inch had a general body checkup, reports will be posted along with. Symptoms like tiredness, fatigue and dyspnea on exertion with sweating are there since a couple of years. He is not willing currently for a bariatric surgery.

Is planning to start some physical training and dietary changes. Give your suggestions on what management to be done based on preliminary reports to save this patient?