Medical
Treatment for Obesity
Treatment
by a physician may be necessary when an individual's
own efforts to lose weight have failed and/or
when co-existing medical conditions make it crucial
for a person to lose weight. Prescription medication
may be necessary for those having obesity-related
health problems while behavioral measures can
play an important part of any weight loss regimen.
Over-the-counter supplements are used by many
people in an attempt to lose weight. Behavioral
strategies may be used to help change dietary
habits and increase activity levels. Eating disorders
require treatment by a therapist, and may also
require medication.
Specific
treatment for obesity will be determined by your
physician based on:
- your age, overall health,
and medical history
- extent of the condition
- your tolerance for
specific medications, procedures, or therapies
- expectations for the
course of the condition
- your opinion or preference
Medical
treatment for obesity includes, but is not limited
to, the following:
- prescription medications
When other measures, such as dieting and lifestyle
changes, have failed to produce acceptable weight
loss results, medication may be prescribed to
help a person lose weight. While no medication
can work miracles, it may help a person to achieve
modest weight loss that can contribute to improved
health.
The most commonly prescribed medications work
either by blocking the absorption of some fat
(orlistat, or Xenical) or by creating a feeling
of fullness (sibutramine, or Meridia).
Sibutramine helps in achieving a feeling of
fullness more quickly while orlistat reduces
the absorption of about 30 percent of fat as
food travels through the digestive system. Both
drugs have side effects. Sibutramine may increase
blood pressure and may cause dry mouth, constipation,
headache, and insomnia. Orlistat may cause frequent,
oily bowel movements, but if fat in the diet
is reduced, symptoms often improve. Once the
medication is stopped, some or most of the weight
may be regained. These medications may not work
for everyone.
Always consult with your physician.
- supplements
Many over-the-counter supplements promise to
help burn fat faster or reduce hunger. Some
supplements have side effects that can be dangerous.
A number of these products have not been studied
in clinical trials, so many of the effects,
benefits, and risks are not well known.
Ephedra (ma-huang) contains an ingredient used
in asthma medication. Dietary supplements containing
ephedra have been banned by the US Food and
Drug Administration (FDA) because of potentially
dangerous side effects.
Products that work as a laxative can cause the
blood's potassium level to drop, which may
cause heart and/or muscle problems. Pyruvate
is a popular product that may result in a small
amount of weight loss. However, pyruvate, which
is found in red apples, cheese, and red wine,
has not been thoroughly studied. Its weight
loss potential has not been scientifically established.
While there is no supplement that can take the
place of eating a healthy diet, a multivitamin
taken daily can help close the nutritional gap
even for those people who eat a balanced diet.
However, vitamin supplements do not produce
weight loss.
Always consult with your physician.
- behavioral strategies
Over the long term, most obese adults who lose
weight will return to their baseline weight
if ongoing behavioral strategies are not used.
There are techniques for initiating and maintaining
changes in lifestyle that may result in sustained
weight loss.
Some behavioral strategies include keeping a
food journal of what was eaten, where food was
eaten, when food was eaten, when hunger occurred,
and the feelings that were present when eating.
A similar activity journal may also be kept.
These techniques are useful to analyze eating
and activity behaviors, so that behaviors that
need to be modified can be identified and strategies
for changing those behaviors can be developed.
A counselor may be helpful with cognitive techniques
that may be used to help change a person's
thinking about body image. A non-food-related
reward system may be developed to help keep
a person on track toward weight loss goals.
Additional behavioral techniques may include
serving food from the stove rather than family
style and never watching television, reading,
or doing another activity while eating.
- psychotherapy for
eating disorders
Eating a large amount of food at one time does
not necessarily make a person a binge eater.
Everyone overindulges from time to time. However,
there are some obese people who binge and purge
(self-induced vomiting or laxative abuse to
get rid of unwanted calories from binge eating)
or eat large amounts of food compulsively without
the purging component. These behaviors are eating
disorders that require treatment by a physician.
Most people who have these disorders are usually
either overweight or obese. It is important
that the eating disorder be treated before an
obese person attempts to lose weight.
Some eating disorders for which psychotherapy
may be prescribed include:
- bulimia - a disorder
in which a person eats compulsively and
then vomits or uses water pills (diuretics),
laxatives, or strenuous exercise to prevent
weight gain. As many as 4 million US adults
and adolescents have this disorder, considered
the most common disordered eating behavior.
Feelings of guilt, shame, and depression
often follow the binge.
- binge eating disorder
- a disorder that resembles bulimia and
is characterized by episodes of uncontrolled
eating or bingeing. It differs from bulimia
in that its sufferers do not purge their
bodies of the excess food by vomiting, laxative
abuse, or diuretic abuse.
Physicians, psychotherapists, and nutritionists
can help a person with an eating disorder. Therapy
can also help modify behavior and attitudes.
Some people benefit from medication and support
groups.
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