Medical Treatment for Obesity
Treatment by a physician may be necessary when an individual’s own efforts to lose weight have failed and/or when co-existing medical conditions make it crucial for a person to lose weight. Prescription medication may be necessary for those having obesity-related health problems while behavioral measures can play an important part of any weight loss regimen. Over-the-counter supplements are used by many people in an attempt to lose weight. Behavioral strategies may be used to help change dietary habits and increase activity levels. Eating disorders require treatment by a therapist, and may also require medication.
Specific treatment for obesity will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the condition
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
Medical treatment for obesity includes, but is not limited to, the following:
- prescription medications
When other measures, such as dieting and lifestyle changes, have failed to produce acceptable weight loss results, medication may be prescribed to help a person lose weight. While no medication can work miracles, it may help a person to achieve modest weight loss that can contribute to improved health.
The most commonly prescribed medications work either by blocking the absorption of some fat (orlistat, or Xenical™) or by creating a feeling of fullness (sibutramine, or Meridia™).
Sibutramine helps in achieving a feeling of fullness more quickly while orlistat reduces the absorption of about 30 percent of fat as food travels through the digestive system. Both drugs have side effects. Sibutramine may increase blood pressure and may cause dry mouth, constipation, headache, and insomnia. Orlistat may cause frequent, oily bowel movements, but if fat in the diet is reduced, symptoms often improve. Once the medication is stopped, some or most of the weight may be regained. These medications may not work for everyone.
Always consult with your physician.
- supplements
Many over-the-counter supplements promise to help burn fat faster or reduce hunger. Some supplements have side effects that can be dangerous. A number of these products have not been studied in clinical trials, so many of the effects, benefits, and risks are not well known.
Ephedra (ma-huang) contains an ingredient used in asthma medication. Dietary supplements containing ephedra have been banned by the US Food and Drug Administration (FDA) because of potentially dangerous side effects.
Products that work as a laxative can cause the blood’s potassium level to drop, which may cause heart and/or muscle problems. Pyruvate is a popular product that may result in a small amount of weight loss. However, pyruvate, which is found in red apples, cheese, and red wine, has not been thoroughly studied. Its weight loss potential has not been scientifically established.
While there is no supplement that can take the place of eating a healthy diet, a multivitamin taken daily can help close the nutritional gap even for those people who eat a balanced diet. However, vitamin supplements do not produce weight loss.
Always consult with your physician.
- behavioral strategies
Over the long term, most obese adults who lose weight will return to their baseline weight if ongoing behavioral strategies are not used. There are techniques for initiating and maintaining changes in lifestyle that may result in sustained weight loss.
Some behavioral strategies include keeping a food journal of what was eaten, where food was eaten, when food was eaten, when hunger occurred, and the feelings that were present when eating. A similar activity journal may also be kept. These techniques are useful to analyze eating and activity behaviors, so that behaviors that need to be modified can be identified and strategies for changing those behaviors can be developed.
A counselor may be helpful with cognitive techniques that may be used to help change a person’s thinking about body image. A non-food-related reward system may be developed to help keep a person on track toward weight loss goals. Additional behavioral techniques may include serving food from the stove rather than family style and never watching television, reading, or doing another activity while eating.
- psychotherapy for eating disorders
Eating a large amount of food at one time does not necessarily make a person a binge eater. Everyone overindulges from time to time. However, there are some obese people who binge and purge (self-induced vomiting or laxative abuse to get rid of unwanted calories from binge eating) or eat large amounts of food compulsively without the purging component. These behaviors are eating disorders that require treatment by a physician. Most people who have these disorders are usually either overweight or obese. It is important that the eating disorder be treated before an obese person attempts to lose weight.
Some eating disorders for which psychotherapy may be prescribed include:
- bulimia - a disorder in which a person eats compulsively and then vomits or uses water pills (diuretics), laxatives, or strenuous exercise to prevent weight gain. As many as 4 million US adults and adolescents have this disorder, considered the most common disordered eating behavior. Feelings of guilt, shame, and depression often follow the binge.
- binge eating disorder - a disorder that resembles bulimia and is characterized by episodes of uncontrolled eating or bingeing. It differs from bulimia in that its sufferers do not purge their bodies of the excess food by vomiting, laxative abuse, or diuretic abuse.
Physicians, psychotherapists, and nutritionists can help a person with an eating disorder. Therapy can also help modify behavior and attitudes. Some people benefit from medication and support groups.
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