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Treatments of Obesity

Obesity can be treated with a combination of weight loss reduction and maintenance program under the supervision of a physician or a nutritionist. This often produces an average weight loss of about 8% of the total body mass. It may include at least 30 minutes of daily exercise along with high-carb, high-fibre, low-fat diet, counselling to alter eating behaviour, support from family and friends, and some medications. These medications are recommended for people who do not respond to normal dietary changes and behavioural counselling.

While many medications are available for weight-loss, they should be taken only under the care of a doctor. For example, Fenfluramine, an appetite-suppressant drug, was withdrawn because it had serious side-effects. Phentermine, another drug, is suitable for short-term treatments only. Sibutramine or Meridia can be used for longer periods of time, but it has a few side effects like increasing your blood pressure. Orlistat or Xenical can also be used long-term and it is an effective drug because it prevents the body from absorbing fat by inhibiting pancreatic lipase but it causes side effects like greasy stool and you must include fat-soluble vitamins in your diet while taking this drug.

For diabetes mellitus, metformin or Glucophage can help in weight reduction instead of sulfonylurea and insulin, which may result in weight gain. Thiazolidinediones like rosiglitazone and pioglitazone can increase weight, but they help in reducing some types of abdominal fat which helps those with obese diabetics.

Surgery, for example, Roux-en-Y gastric bypass surgery (RNY), is used a last resort and only for morbid obesity of more than 40+ BMI. Biliopancreatic diversion as well as VBG or vertical banded gastroplasty, colloquially known as stomach stapling, are also used for weight loss. Even though it reduces obesity, surgery should be performed by an experienced surgeon due to the many risks associated with it. Other methods like the use of a gastric band is a better, non-invasive solution. Here, an adjustable ring made from silicon is placed around the stomach to reduce food intake.

9 of 10 people who lose weight regain it back within 5 years so maintaining weight after shedding excess fat is often difficult. This is because homeostatic mechanisms like leptin resist weight loss and the American College of Physicians suggests that pharmacotherapy be offered along with counselling for people with a BMI of 30+. Drugs like diethylpropion, fluoxetine, and adbupropion are also useful.

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