How is obesity treated?

The treatment of obesity needs to be long-term; it cannot be short-term. Weight loss should be gradual, and careful follow-up is necessary to prevent rebound weight gain. Changing behavior and lifestyle are the only ways to change a person's weight permanently. These changes focus on gradual and permanent changes in eating and exercise habits. There are six ways you can change your behavior and lifestyle that will help you maintain weight loss:

  • Learning about nutrition
  • Changing your eating habits
  • Increasing your physical activity
  • Changing your attitudes about eating
  • Joining a weight loss program
  • Developing support systems
  • Following any drug therapies ordered by your doctor

The keys to weight management include making lifestyle changes, such as increasing exercise and activity and changing dietary habits.

What about prescription weight loss medications?

Prescription drugs are another approach to treating obesity. Drug therapy may help the patient learn and adapt to a healthier lifestyle. It should be used along with a program of diet and exercise and should help you follow your overall treatment plan.

The anti-obesity medications that are currently available work mainly by suppressing the appetite. They raise specific hormones such as noradrenalin or serotonin in the nervous system, creating a feeling of fullness. These medications will not work, however, unless you also make changes in your diet and lifestyle.

The level of success with anti-obesity drugs is rather modest. Studies show a mean weight loss of six to 10 pounds total and about one-half pound a week greater weight loss than with a placebo (for 12 weeks or less of treatment). Some individuals respond very well while others may not respond at all.

A weight loss medication is not a cure-all. The use of weight loss medications should be combined with physical activity and improved diet to lose and maintain weight successfully over the long term.

Weight loss medications can be considered for:

  • People with a BMI greater than 30 with no obesity-related conditions
  • People with a BMI of greater than 27 with two or more obesity-related conditions

Currently, most available weight-loss medications approved by the FDA are for short-term use, meaning a few weeks or months.

What about weight loss surgery?

Another treatment option may be surgery. Surgery should only be considered after all other attempts to lose weight have been unsuccessful, or if a person has an obesity-related disease. Surgery should only be done at centers committed to long-term follow-up and as an addition to diet, exercise, and behavior modification programs. Currently, candidates for these surgeries have to be:

  • Severely obese (A BMI greater than 35)
  • Well-informed
  • Assessed by dietician, psychologist, endocrinologist, and other specialists before being considered for the procedure

Surgical procedures have had the most long-term success, but it is important to consider the reasons for success or failure of previous weight-loss attempts as well as the risks and benefits of the surgery.

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