The exact
method of treatment depends on your level of obesity, overall health condition,
and motivation to lose weight.
Treatment
for obesity may include a combination of diet, exercise, behavior modification,
and sometimes weight-loss drugs. A combination of diet and physical
activity (in conjunction with behavioural counseling) is probably more
effective in sustaining weight loss than diet or exercise alone in adults.
The type of physical activity does not seem important.
In some
cases of severe obesity, gastrointestinal surgery may be recommended.
Obesity
reduction and weight control is a life-long effort and may involve a
series of major changes in eating habits, physical exercise routines
and general lifestyle. The overwhelming evidence is that overweight
and obese people should be encouraged to integrate changes to their
lifestyle over a longer period of time to maintain the benefit of initial
weight loss. A combination of decreased food intake and increased physical
activity is more likely to lead to sustained weight loss.
Types
of Obesity Treatment
As stated,
the treatment of obesity and long term weight control involves a number
of elements. Here are the some of the main ways in which the problems
are approached.
1. TREATING
OBESITY WITH BEHAVIORAL THERAPY/COUNSELING
Obesity
Treatment - Behavioral and Family Counseling
Behavior
modification and behavioural skills training to modify eating and physical
activity habits to prevent weight regain are often used.
Behavioral
counseling sessions involve all members of the family rather than individual
counseling of the affected member (to be used in the prevention of obesity
in children specifically).
Family
therapy is more effective than conventional diet and exercise in preventing
weight gain in children (but not necessarily in treatment of obesity).
Obesity
Treatment - Dietary Counseling
Two main
types of dietary therapy are a low calorie diet (800–1500 kcal
daily), and a very low calorie diet (less than 800 kcal of energy daily),
which usually consists of a protein-enriched liquid.
Energy
consumption must be reduced. High calorie/low volume foods should be
avoided and replaced with an increase in complex carbohydrates (such
as whole grain foods) and an increase in fruit and vegetables.
A reduced
fat intake is also an important element of a balanced healthy diet.
Very low
calorie diets are not advisable in children and they are not effective.
Obesity
Treatment - Exercise Counseling
The primary
goal is to move sedentary people into an active category (even if it
is moderate levels of intensity) and to move moderate level individuals
into more vigorous levels.
It is
more effective to promote less sedentary lifestyles (with less opportunity
to eat excessively while watching TV, for example) than simply attempt
to increase activity.
Accumulation
of daily physical activity should be the key if 30 minutes at least
five times a week seems unobtainable.
Modest,
regular bouts of physical activity can lead to benefits. The type of
exercise is not important and short bouts of walking can cumulatively
be of much benefit.
Walking
a mile a day for a year is equivalent in energy to that stored in 7
pounds of adipose (fat) tissue.
Habitual
physical activity can also help keep weight off after weight loss has
been achieved, and can reduce the threat of the post-weight-loss seesaw
effect.
In terms
of increasing children’s physical activity, a more active daily
lifestyle should be encouraged rather than structured aerobic exercise
schedules.
Obesity
Treatment - An Incremental Approach Works Best
A number
of themes are emerging on what strategies are the most effective in preventing
obesity. A gradual, incremental stepwise approach seems to have the most
beneficial long-term effect.
Small, sustainable
modifications in diet, exercise and communication are more effective than
restrictive strategies. With small steps, the family/individual can accommodate
the required lifestyle modifications. Evidence for the effectiveness of
obesity prevention and treatment is inconclusive.
2. TREATING
OBESITY WITH WEIGHT LOSS DRUGS
If your doctor
determines that you have obesity-related health problems or are at high
risk for such problems, and if you have been unable to lose weight or
maintain weight loss with nondrug treatment, he or she may recommend that
you use prescription weight-loss medications.
Weight-loss
medications may be appropriate for carefully selected patients who are
at significant medical risk because of their obesity.
They
are not recommended for people who are only mildly overweight unless
they have health problems that are made worse by their weight.
These
medications should not be used only to improve appearance.
3. TREATING
OBESITY WITH WEIGHT LOSS SURGERY
Obesity
Treatment - Gastrointestinal Surgery
Gastrointestinal
surgery is a viable option for people who remain severely obese after
trying nonsurgical approaches, or who suffer from serious obesity-related
health problems. The surgery promotes weight loss by restricting food
intake and, in some operations, interrupting the digestive process. As
in other treatments for obesity, the best results are achieved with healthy
eating behaviors and regular physical activity.
Candidates
for Weight Loss Surgery
People who
may consider gastrointestinal surgery include:
Those
with a body mass index (BMI) above 40 - about 100 pounds of overweight
for men and 80 pounds for women.
People
with a BMI between 35 and 40 who suffer from type 2 diabetes or life-threatening
cardiopulmonary problems such as severe sleep apnea or obesity-related
heart disease.
Weight Loss
Surgery - No Guaranteed Cure for Obesity
There are
no guarantees for any obesity-treatment method, including gastrointestinal
surgery, to produce and maintain weight loss. Success is possible only
with maximum cooperation and commitment to behavioral change and medical
follow-up - and this cooperation and commitment must be carried out for
the rest of your life.
