Obesity – Management

Obesity management involves healthy eating like this couple eating a plate of vegetables

Obese men and women tend to spend an incredible amount of money on obesity management in their attempts to become thin by buying special foods and medicines. The cheapest and most effective way to loose weight is to spend less by buying less food, particularly less of the expensive processed foods. If you find your willpower is lacking or the craving for rich foods becomes unbearable, doctors can prescribe tablets that are designed to reduce your appetite (anorectics). These drugs are expensive, and should not be used for long periods, but they are effective.

Orlistat (Xenical) is a drug that reduces the body’s ability to absorb fat, and is quite successful in assisting obese people to lose weight, but it must be used in conjunction with a diet program and some degree of diarrhoea is an almost invariable side effect.

Sibutramine (Reductil) is a medication that was released in 2002 that acts on the brain to reduce appetite. A weight reduction of 5% can be expected in three months in most patients. It cannot be used by patients who are on some antidepressants and patients with heart disease or high blood pressure, blood pressure must be monitored regularly and the medication is quite expensive. There are many other groups who should not use this medication, including those over 65 years. Its use should be carefully discussed with a doctor.

Phentermine (Duromine) is another medication used to reduce appetite in obesity. It is less commonly used these days due to the significant risk of dependence and addiction.

There are also food substitutes that can be used to replace meals and primarily contain non-absorbable fibre such as cellulose.

As a last resort, surgical procedures that reduce the size of the stomach (bariatric surgery, gastric banding) or salt water filled balloons that sit in the stomach (intragastric balloon) can be used to aid the patient in their dieting.

If those who are medically overweight reduce their weight by just 10%, they will:-

  • reduce blood pressure by 10 to 20 mm.
  • reduce the symptoms of angina by 90%
  • reduce the bad forms of cholesterol in their blood
  • reduce the risk of developing diabetes by 50%
  • reduce the risk of death from heart disease, diabetes and cancer by more than 20%
  • improve the quality and quantity of sleep
  • reduce daytime drowsiness
  • increase sexual desire and activity
  • improve overall assessment of health by more than 20%

The long-term success rate for those who are truly obese and try to lose weight is very discouraging. Most have yo-yo weights, which fluctuate up and down over the years by 20 Kg. or more as they try different diets and exercise programs. This weight fluctuation can be more harmful than staying fat. Overall, less than one in twenty of obese people manage to return to within normal weight limits and stay there for more than five years.

If you do manage to stay on a diet for about five years, and maintain your weight constantly within the desired range, the body will adapt to its new shape, and the metabolic rate may also adjust, so that you may suddenly find after years of dieting that you can relax a little, and still maintain the new weight.

Those with a metabolic cause for their obesity must have the underlying condition treated, and not the obesity itself.

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