Obesity:

How is it treated?

The FDA is calling the nation’s obesity problem an “epidemic” and released a report in 2004 with goals and actions focusing on a campaign entitled, “Calories Count.” Recommended actions include:

• enhancing the food label to display calorie count more prominently and to use meaningful serving sizes
• initiating a consumer education campaign focusing on the "Calories Count" message
• encouraging restaurants to provide nutritional information to consumers
• stepping up enforcement actions concerning accuracy of food labels
• revising FDA guidance for developing drugs to treat obesity
• working cooperatively with other government agencies, non-profits, industry, and academia on obesity research

Obesity is associated with increased morbidity and mortality. Weight loss reduces risk factors for complications associated with the excess weight, including diabetes and cardiovascular diseases. There are several treatment options for the management of overweight and obese individuals, including diet therapy, changes in physical activity, behavioral therapy, drug therapy, surgery and a combination of these.

The initial goal of weight loss therapy is to decrease body weight by about 10%. Once this goal is met, then further weight loss can be attempted. This weight loss will not occur overnight, but you can see a difference over mere weeks if you stay with your program. Once the weight is lost, maintenance of the loss needs to be implemented to ensure that the weight stays off.

Diet Therapy

Lifestyle modifications such as increasing physical activity and decreasing calorie intake are recommended instead of "dieting." Crash diets should definitely be avoided. The best approach to changing your diet is to talk to your doctor to find out what is best for you. Your doctor can provide you with dietary guidelines or refer you to a dietician for further help. Dietary guidelines will differ for each person depending on height, weight, concurrent health conditions, and desired amount of weight loss. A diet must be established that will allow for weight loss and be easy to comply with. Maintenance of your program is the key to keeping the pounds off.

Exercising is important to any good weight loss program. An aerobic exercise program reduces weight loss regardless of any changes you make in your diet. Adding 45 minutes of aerobic exercise a day is the equivalent of losing 400-800 Calories depending on your intensity. Minimally, that would result in losing one pound per week. Even if you can only exercise three times per week, that would still help you lose almost 2 pounds per month or 20 pounds over a year! Remember that this is without any changes in your diet. Dropping 500 Calories a day from your diet (the equivalent of one large French fries) will double your results.

Weight training and calisthenics also help you to reduce weight not by direct loss but by decreasing fatty tissue and increasing lean body mass. This will increase your metabolism and burn more calories while at rest.

Obese patients should start slowly with low-intensity walking or swimming and advance intensity as tolerated. If you have cardiovascular disease or other conditions that may make exercise very difficult, talk you your physician before you begin.

Behavioral Therapy

Behavior modification is common to all weight loss programs. Modification includes strategies that aid individuals to overcome barriers to comply with dietary changes and physical activity. Most behavioral modification programs encourage self-monitoring of both diet and exercise to increase one's own awareness of the activities. Modification strategies may also include stress management, social support, and stimulus control.

Combining behavioral therapy, diet therapy, and increased physical activity should be considered as initial "therapy" for weight loss. This combination should be continued for at least 6 months before proceeding to drug therapy.

Drug Therapy

After all other modes of losing weight have failed, you should talk to your physician about your options with drug therapy. Medications can be used to stimulate weight loss by either decreasing the appetite or inhibiting the absorption of fat from the intestines. Also, certain antidepressants such as fluoxetine (Prozac) and sertraline (Zoloft) may suppress the appetite by regulating levels of serotonin, a neurotransmitter in the brain. Serotonin is thought to induce a feeling of hunger and fullness. Click on the links below to learn more about available prescription medications that can aid in weight loss.

Many health food and supplement stores promote various "natural" or herbal products for weight loss. Even though they claim to be effective and "natural," these products can be associated with certain harmful side effects. The U.S. Food and Drug Administration (FDA) has stringent rules pertaining to the safety, efficacy, and quality that pharmaceutical manufacturers must follow in order to market drugs in the U.S. Manufacturers of herbal supplements do not have to follow these same rules to sell their products. For this reason, there is limited research evaluating supplements' safety and efficacy in the human body. As a result, anyone who chooses to take these substances does so at their own risk.

The most important thing to remember is that weight loss takes time and effort, and is a lifelong process. Also, it is important to set reasonable goals. Sensible weight loss does not occur overnight and it takes major changes in your lifestyle before significant changes in weight may be observed. Permanent weight loss can be reached by continued lifestyle changes.