Health encyclopaedia - Alphabetical Topic List

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Treatment of Obesity

Calorie control is the least difficult treatment. There are two aspects to this:

  • Use a food diary to record everything you eat and drink on a daily basis.  Work out your average calorie intake and then cut out 500 calories per day from what you’re eating. This doesn’t amount to a big sacrifice, and you’ll still be able to enjoy a range of food. The important thing is to be honest about what you’re eating.
  • Increase the amount of aerobic exercise you do. A rough guide is to do anything that makes you work hard for 30 minutes three times a week. You know you’re working hard if you’re panting and mildly sweating and have a raised heart rate. Check with your GP that any planned activity is safe for you. Find a way to exercise that you find enjoyable, as this will help you to stick with it.

No weight-loss programme should aim for a loss of more than 1 kilogram per week. Half a kilogram per week is quite respectable, and any weight-loss programme that claims a more rapid loss than this may be unhealthy.

Serious weight loss is a long-term commitment to yourself and it involves time and stamina. It may not be easy, but the results are very rewarding.

Drug therapy

Medical treatment for obesity is available, but only in extreme cases. treatment currently available can only be prescribed if you can demonstrate weight loss on a calorie-controlled diet first.

A lot of stimulant appetite-suppressant drugs have been used in the past, but many have been found to be dangerous. The stimulant drugs are based on amphetamine and carry a risk of sudden death from fatal heart rhythms.

Drugs are sometimes prescribed for patients who are unable to lose weight by changing their diet and increasing their activity levels. Orlistat is a pancreatic lipase inhibitor, which means that it reduces the body’s ability to absorb fat. It may be used in conjunction with a low fat diet to achieve more rapid and greater weight loss.  If a low fat diet is not used there may be unwanted side effects. Before your doctor will prescribe Orlistat, you must show that you are motivated to lose weight and have lost 2.5kg prior to treatment.

Another drug recently approved for the treatment of obesity in the UK is Sibutramine. This works in the brain by altering the chemical messages that control how the person taking it feels and thinks about food. It mainly affects two chemicals called noradrenaline and serotonin and promotes a feeling of being full or having eaten enough. It is only prescribed to obese people with a BMI of over 30 or those with a BMI of over 27 with life-threatening conditions such as high cholesterol or Type II diabetes and who have made serious attempts to lose weight by dieting, exercise and/or other changes in their behaviour.

 If either of these drugs is prescribed for you, you will also be offered advice, support and counselling on diet, exercise and behaviour changes.

Surgery

Severe obesity is a chronic condition that is very difficult to treat. Surgery to promote weight loss by restricting food intake or interrupting digestive processes is an option for severely obese people. A body mass index above 40 indicates that a person is severely obese and therefore a candidate for surgery. Surgery also may be an option for people with a BMI between 35 and 40 who suffer from life-threatening cardiopulmonary problems for example, severe sleep apnoea, obesity-related heart disease or diabetes. However, as in other treatments for obesity, successful results depend mainly on motivation and behaviour.