Obesity Treatment Overview

Obesity Treatment Overview

Treatment goals

Regardless of the type or
combination of obesity treatment, goal setting is an important part of any obesity
treatment plan. While a person may want to lose a large amount of weight, it’s important
to realize that setting and achieving a realistic goal of reducing weight by as little
as 3% to 5% of body weight will yield important, positive gains in health.

Treatment goals work best if they
are tailored to a person’s needs. For example, it’s safe to lose 1 or 2 pounds per
week,
but a person may be more comfortable losing at a lower rate of one-half pound per
week.
Over one year, that is a 26-pound loss. If that rate is maintained over 3 years, it
will
lead to a significant weight loss of 78 pounds over time. Whatever treatment plan
a
person follows, losing weight slowly will be more effective and healthy over the long
term. Quick weight loss often spurs weight regain.

Treatment for obesity

Treatment for obesity may include a combination of different types of treatment. Always
talk with your healthcare provider for a diagnosis and treatment recommendations.

There are a variety of ways to
treat obesity. Using more than one method, such as making diet changes as well as
adding
exercise, are beneficial.

Diet

Although diet plans high in
protein and fat and low in carbohydrates are popular, some of these diets may pose
serious health risks in the long run because of the emphasis on saturated fat.
Successful weight loss that is maintained over a long period of time depends more
on
limiting energy consumed (calories) and increasing energy expenditure (exercise and
daily activity) than just the composition of the diet.

Fasting may result in rapid
weight loss, but lean muscle mass may be lost as well as fat. All-liquid diets must
be medically supervised. They may be used for a short time in people who are obese.
Although these liquid diets may be effective in the short term, they are not the
long-term answer to weight loss.

Fads, fasting, and popular diets in which health effects have not been determined
by rigorous clinical trials may not be healthy choices for weight loss. However, there
are dietary recommendations that, if followed, will lead to weight loss:

  • To lose weight and keep it
    off for a lifetime, think about an individualized eating plan instead of a
    “diet.” A plan tailored to your personal likes and dislikes will have a better
    chance of producing lasting weight loss. A balanced diet that is restricted in
    calories—1,200 to 1,400 calories a day for women and 1,500 to 1,800 calories a
    day for men—may work well. A registered dietitian can help to make an
    individualized diet plan based on a person’s particular situation.

  • Include a variety of foods in the diet.

  • All fats are not bad. It’s
    now known that polyunsaturated and monounsaturated fats provide health
    benefits, such as helping to keep the heart healthy. This means that nuts,
    seeds, and some types of oils, such as olive, safflower, and canola, have a
    place in a healthy eating plan.

  • Choose whole grains, such
    as brown rice and whole-wheat bread, rather than white rice and white bread.
    Whole grain foods are rich in nutrients compared to more processed products.
    They are higher in fiber and therefore absorbed by the body more slowly so
    they don’t cause a rapid spike in insulin which can trigger hunger and
    cravings.

  • Choose at least 5 servings daily of fruits and vegetables. Be sure to pick a variety
    of fruits and vegetables because different fruits and vegetables contain varying amounts
    and types of nutrients.

  • When dining out or ordering take-out food, ask for a take-home box (and use it). Avoid
    super-size selections when you order. Many restaurant portions are too large for one
    person. Consider sharing an entree or ordering an appetizer instead of a main dish
    from the entree menu.

  • Read food labels carefully. Pay particular attention to the number of servings contained
    in the product and the serving size. If the label says a serving is 150 calories and
    the number of servings per container is 3, the calories are triple, or 450 calories,
    if the entire product contents are consumed.

Exercise

A regular exercise program
helps people who are obese by helping keep and add lean body mass, or muscle tissue,
while losing fat. It also helps to increase the rate at which weight is lost if a
person is eating healthy food according to a meal plan. This is because muscle tissue
burns calories faster.

Walking is an excellent choice of exercise for people who are obese. A walking program
should start slowly by walking 30 minutes a day a few days a week. Increase gradually
to the goal of walking for longer periods most days of the week. If you have severe
arthritis and walking is difficult, water walking in a swimming pool is a very effective
means of exercise. There is minimal weight bearing on the knees with this exercise.
Some fitness centers also offer water aerobics.

Exercise lowers blood pressure
and can help prevent type 2 diabetes. Exercise also helps improve mood, reduce
appetite, improve sleep, improve flexibility, and lower LDL cholesterol (the bad
cholesterol).

Check with your healthcare provider before starting any exercise program.

Environmental factors

Many U.S. adults have a
sedentary lifestyle. Becoming active takes effort on your part. Use of the car and
working at a desk restrict activity. Watching TV is a sedentary activity that can
contribute to an inactive lifestyle.

There are simple steps that can be taken to increase daily activity:

  • Take the stairs instead of the elevator or escalator.

  • Park the car at the far
    end of the parking lot and walk to the store or the office if safe.

  • Get off the bus one stop early if you are in an area safe for walking.

  • Turn off the TV or video game and head for the garden, rake the leaves, wash the car,
    or take a walk.

  • Walk on a treadmill or ride a stationary bike when you watch TV.

  • Find activities that the whole family will enjoy, such as tennis, skating, biking,
    or hiking.

By looking at a person’s daily
routine, it may be easier than first imagined to find ways to work more activity
into the day in addition to exercising.

The workplace may be challenging
when trying to stick to a weight loss plan. However, there are strategies that may
help to keep a weight loss plan on track at work. Bring healthy snacks, such as
cut-up fruits and vegetables, to keep on hand when the pastry cart rolls by. Avoid
going to office social gatherings hungry. Plan ahead to avoid the temptation of
treats that are high in sugar and fat. Ask your employer if he or she can allow an
exercise program to be built into your work schedule. You may be able to use a
treadmill while you work. Some people also benefit from working at a standing desk
instead of sitting all day.

Support groups

Join a support group for
encouragement and reinforcement of changing lifestyle behaviors. Some groups meet
weekly and are run by volunteers, psychologists, nutritionists, or exercise
therapists. There are also online communities that can help provide support and
information to strengthen efforts to lose weight and make lifestyle changes. Friends
and family can also provide important support when making lifestyle changes. Although
commercial weight loss programs can be expensive, many of them offer the convenience
of prepared food. Some of these programs also provide professional consultation to
help a person to tailor his or her weight loss efforts to his or her needs.

Medical treatment

Treatment by a healthcare
provider may be necessary when efforts to lose weight have been unsuccessful ,yet
coexisting medical conditions make it crucial to lose weight. Medicine may be
necessary for those having obesity-related health problems and, while medicines may
help, they are not the “magic” bullet. Behavioral measures play an even more
important part in any weight loss regimen. Behavioral strategies can be used to help
change dietary habits and increase activity levels. Eating disorders need treatment
by a therapist and may also need medicine.

Surgical treatment

Weight-loss surgery (bariatric surgery) is the only choice today that effectively
treats morbid obesity in people for whom more conservative measures, such as diet,
exercise, and medicine have failed. Potential candidates include:

  • People with a body mass
    index (BMI) greater than 40

  • Men who are 100 pounds over their ideal body weight or women who are 80 pounds over
    their ideal body weight

  • People with a BMI between
    35 and 40 who have another serious weight-related condition, such as
    obesity-related type 2 diabetes, asthma, sleep apnea, arthritis, or heart
    disease

There are several different
types of bariatric surgery, but all procedures are either malabsorptive, restrictive,
or a combination of the two. Malabsorptive procedures change the way the digestive
system works. Food is rerouted past a part of the small intestine that absorbs some
calories and nutrients. With some procedures, there is a restrictive part of the
procedure as well. These procedures are commonly referred to as “gastric bypass”
procedures or the more aggressive duodenal switch with biliopancreatic
diversion. 

Restrictive procedures severely reduce the size of the stomach to hold less food,
but the digestive functions remain intact. This type of procedure may be referred
to as a “gastric banding,” or vertical sleeve gastrectomy.

Typically, malabsorptive
procedures result in more weight loss than restrictive procedures. They also lead
to
more nutritional deficiencies over time.

Always talk with your healthcare provider to find out more information.