First, you may think the goal of obesity treatment is just to reduce the patient’s body mass down to normal level. However, it is not the whole point of the treatment. You should bear in mind that the maintenance of body mass (BM) achieved during the treatment is also an important task in the patient’s treatment process.At the beginning of obesity treatment, it turns out that the patient has different obesity-related diseases. In these situations, before choosing the obesity treatment type, one should take under control the course of comorbidities he has, and start their treatment timely.

There are several common methods of obesity treatment.

  • Nutritional care (diet therapy)
  • Lifestyle change (increase of physical activity)
  • Pharmacotherapy (use of medications)
  • Surgical treatment (treatment by means of connection and separation of tissues during surgical interference)

Diet therapy

  • Strangely enough, but obesity can be cured by means of food.

Not long ago, people used to cure obesity by starving themselves, but according to the latest studies, such method has many negative consequences. The truth is that food delivers not only calories, but also many other essential nutrients. This is the essence of diet therapy.

Actually, diet therapy can be used in the treatment of many other diseases. It happens that the diet therapy shows some great results when other treatment methods are ineffective.

The advantage of the diet therapy is that it requires no artificial intervention in the complex process of vital activity.

Lifestyle change (increase of physical activity)

Our modern life does not involve much of physical exertion to get food (as it was in the early stages of evolution).

  • The fact is that most people are not motivated to severe physical exertion, on contrary; many of them tend to lead a sedentary lifestyle.

Scientists have established that regular workouts (minimum 25 minutes a day) can burn up about 20% of fat and even more. The effect is greater if person works out in the morning. Herewith, workouts do not necessarily have to be exhausting. A regular walking, morning gymnastics, swimming, jogging or biking may help to get rid of excess weight.

Remember that active lifestyle consumes undistributed energy. People, who are involved in sports, never suffer from obesity.

Besides that, sports has a positive effect on the respiratory tract, improving the blood flow and body metabolism.

Pharmacotherapy (use of medications)

Pharmacotherapy is administered to patients with the body mass index (BMI) above 30 kg/m², or more than 27 kg/m², accompanied by:

Coronary artery disease (insufficient blood supply to the heart muscle)
Abdominal obesity (obesity of the upper part of the body, typical for males)
Hypertonic disease (high blood pressure)
Hereditary predisposition to type II diabetes (defect in insulin secretion)
Comorbidities or risk factors – dyslipidemia (high level of lipoproteins and / or lipids in the human blood), diabetes mellitus
Cardiovascular diseases (vascular disease, damage to the heart muscle, formation of blood clots, etc.)

Pharmacotherapy is carried out under the supervision of a doctor. Weight loss is the first stage of obesity treatment (loss of 10% – successful treatment, 20% – excellent treatment, over 30% – outstanding treatment).

The second stage of obesity treatment is to maintain the achieved weight. This stage is considered a successful one, if patient gains less than 4 kg within 2 years, and if the patient has a persistent reduction in waist circumference (3 cm per year).

Pharmacological drugs for obesity treatment are conventionally divided into three groups.

First group: centrally acting drugs. These medications provide an effective weight loss by acting on the metabolism, changing the appetite or caloric intake. These drugs are also called anorexigenic agents (Phentermine, Sibutramine, Duromine, Fluoxetine and Metermine).

Second group: peripherally acting drugs (Orlistat, Xenical, Metformin, Troglitazone) are also divided into 2 groups by their effect:

Obesity Treatment
  • Gastrointestinal lipase inhibitors, long-acting drugs, preventing fat absorption in the gastrointestinal tract.
  • Drugs increasing peripheral glucose metabolism in muscles; reducing the glucose synthesis, improving the blood lipid profile (Siofor and other biguanides).

Third group: mixed action (central and peripheral) drugs, thermogenic sympathomimetics, androgens and growth hormone.

Surgical treatment (bariatric surgery)

Bariatric surgery is carried out when other methods of obesity treatment are ineffective. This kind of procedure is indicated to patients when their weight is above the norm and the BMI is over 40 kg/m².

Gastric banding (GB) implies the application of special band on the upper part of the stomach. After this procedure, the stomach gets an hourglass shape. The upper part of the stomach accommodates 45 ml of food. Because namely the upper stomach contains satiety receptors, so when it is full, person is not hungry.

The advantage of this surgery is that one can change the diameter of the band any time he wants, and this will help to control the satiety during meals. Other advantage is that this surgery does not require a surgical interference into the gastrointestinal tract.

Gastric bypass surgery

  • Gastric bypass surgery is a simple surgical procedure, during which a surgeon leaves just a small part of stomach for a digestive process. As a result, a smaller amount of food is digested into gastrointestinal tract, causing weight loss.

After the bypass surgery, a new gastrointestinal tract is made up, which moves food from the stomach into intestine bypassing the active absorption area.

Advantages of gastric bypass surgery:

Stomach becomes smaller
Digestion does not involve the activity of duodenum, where all the nutrients are typically absorbed from food (especially fat and carbs, those elements that contribute to a rapid weight gain)
Liquid food comes in intestines much faster
The stomach’s ability to grind and digest food up to a desirable consistency is significantly reduced.

In addition, one can reduce the stomach volume by inserting a special balloon with solution into it (400-600 ml). The balloon is inserted for a period of 6 months to reduce the body weight before the bariatric surgery.

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