Obesity
Treatment Overview
Regardless
of the type or combination of obesity treatment,
goal setting is an important part of any obesity
treatment plan. While a person may want to lose
a large amount of weight because of societal or
fashion reasons, it is important to realize that
setting and achieving a goal of reducing weight
by as little as 5 percent to 10 percent of body
weight will yield important, positive gains in
health.
Treatment
goals work best if they are individualized. For
example, it is safe to lose one to two pounds
per week, but a person may be more comfortable
losing at the rate of one-half pound per week.
Over one year, that is a 24-pound loss and, if
that rate is maintained over three years, will
lead to a significant 78-pound loss. Whatever
treatment plan a person follows, losing weight
slowly will be more effective and healthy over
the long term because quick weight loss often
spurs weight regain.
Specific
treatment for obesity will be determined by your
physician based on:
- your age, overall health,
and medical history
- extent of overweight
or obesity
- your tolerance for
specific medications, procedures, or therapies
- expectations for the
course of the condition
- your opinion or preference
In addition,
treatment for obesity may include a combination
of treatment types. Always consult your physician
for a diagnosis.
There
is a variety of methods used to treat obesity.
Incorporating multiple methods, such as making
diet changes as well as adding exercise, may be
beneficial. These methods include, but are not
limited to, the following:
- diet
Although diet plans high in protein and fat
and low in carbohydrates are gaining in popularity,
some of them may pose serious health risks in
the long run because of the emphasis on saturated
fat. Successful weight loss that is maintained
over a long period of time depends more on limiting
energy consumed (calories) and increasing energy
expenditure (exercise and daily activity) than
the composition of the diet.
Fasting may result in rapid weight loss, but
lean muscle mass is lost as well as fat. All-liquid
diets must be medically supervised and may be
used for a short period of time in people who
are obese, but these diets are not the long-term
answer to weight loss.
Fads, fasting, and popular diets in which health
effects have not been determined by rigorous
clinical trials may not be healthy options for
weight loss. However, there are dietary recommendations
that, if followed, will lead to weight loss:
- To lose weight
and keep it off for a lifetime, begin thinking
about an individualized eating plan instead
of a "diet." A plan tailored to
personal likes and dislikes will have a
better chance of producing sustainable weight
loss. A balanced diet that is restricted
in calories - 1,200 to 1,400 calories for
women and 1,500 to 1,800 calories for men
- may work well. A registered dietician
can help to make an individualized diet
plan based on a person's particular
situation.
- Include a variety
of foods in the diet.
- All fats are not
bad. It is now known that polyunsaturated
and monosaturated fats provide health benefits
such as helping to keep the heart healthy.
This means that nuts, seeds, and some types
of oils, such as olive, safflower, and canola,
have a place in a healthy eating plan.
- Choose whole grains
such as brown rice and whole wheat bread
rather than white rice and white bread.
Whole grain foods are rich in nutrients
compared to more processed products. They
are higher in fiber and therefore absorbed
by the body more slowly and do not cause
a rapid spike in insulin, which can trigger
hunger and cravings.
- Choose at least
five servings daily of fruits and vegetables.
Be sure to choose a variety of fruits and
vegetables, as different fruits and vegetables
contain varying amounts and types of nutrients.
- When dining out
or ordering take-out food, ask for a take-home
box or avoid super-size selections when
you order. Many restaurant portions are
too large for one person, so consider sharing
an entrée or ordering an appetizer
instead of a main dish from the entrée
menu.
- Read food labels
carefully, paying particular attention to
the number of servings contained in the
product and the serving size. If the label
says a serving is 150 calories but the servings
per container is three and the contents
of the entire container are consumed, the
calories consumed is triple, or 450 calories.
- exercise
Exercise benefits people who are obese by helping
to keep and add lean body mass, or muscle tissue,
while losing fat. It also helps to increase
the rate at which weight is lost if a person
is eating healthy food according to a meal plan
because muscle tissue has a higher rate of metabolism,
thus burning calories faster.
Walking is an excellent choice of exercise for
people who are obese. A walking program should
start slowly by walking 30 minutes a day a few
days a week and increase gradually to the goal
of walking for longer periods most days of the
week.
Exercise lowers blood pressure and can help
prevent type 2 diabetes. Exercise also helps
to improve emotional well-being, reduce appetite,
improve sleeping ability, improve flexibility,
and lower LDL cholesterol.
Consult your physician before starting any exercise
program.
- environmental factors
A typical day for most US adults encourages
a sedentary lifestyle, and becoming active takes
some effort. Use of the automobile and working
at a desk restrict activity. Watching television
is a sedentary activity that can contribute
to an inactive lifestyle.
There are simple steps that can be taken to
increase daily activity:
- take the stairs
instead of the elevator or escalator
- park the car at
the far end of the parking lot and walk
to the store or the office
- get off the bus
one stop early if you are in an area safe
for walking
- turn off the television
or video game and head for the garden, rake
the leaves, wash the car, or take a walk
- find activities
that the whole family will enjoy, such as
tennis, roller-blading, or hiking
By looking at a person's
daily routine, it may be easier than first
imagined to find ways to pack more activity
into the day in addition to exercising.
The workplace may
be part of a person's environment that
is not helpful to a weight loss plan. However,
there are strategies that may help to keep
a weight loss plan on track at work. Bring
healthy snacks, such as cut-up fruits and
vegetables, to keep on hand when the pastry
cart rolls by. Avoid going to office social
gatherings hungry - plan ahead to avoid the
temptation of treats that are high in sugar
and fat.
- support groups
Join a support group of people for encouragement
and reinforcement of efforts to help with success
in changing lifestyle behaviors. Some groups
meet weekly and are run by volunteers. There
are also online communities that can help provide
support and information to strengthen efforts
to lose weight and make lifestyle changes. Friends
and family can also provide important support
when making lifestyle changes. Although commercial
weight loss programs can be expensive, many
of them offer the convenience of pre-prepared
food. Some of these programs also provide consultation
to help a person to individualize his or her
weight loss efforts.
- medical treatment
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. Medication may be necessary for those
having obesity-related health problems, while
behavioral measures can play an important part
of any weight loss regimen. Behavioral strategies
can be used to help change dietary habits and
increase activity levels. Eating disorders require
treatment by a therapist, and may also require
medication.
- surgical treatment
Weight-loss surgery (bariatric surgery) is the
only option today that effectively treats morbid
obesity in people for whom more conservative
measures such as diet, exercise, and medication
have failed. Potential candidates include:
- persons with a
Body Mass Index (BMI) greater than 40
- men who are 100
pounds over their ideal body weight or women
who are 80 pounds over their ideal body
weight
- persons with a
BMI between 35 and 40 who have another condition
such as obesity-related type 2 diabetes,
sleep apnea, or heart disease
There are several
approaches to bariatric surgery, but all procedures
are either malabsorptive, restrictive, or
a combination of the two. Malabsorptive procedures
change the way the digestive system works.
Food is re-routed past a large portion of
the stomach and part of the small intestine
that absorbs some calories and nutrients.
With some procedures, a portion of the stomach
is removed. These procedures are commonly
referred to as "gastric bypass"
procedures.
Restrictive procedures
severely reduce the size of the stomach to
hold less food, but the digestive functions
remain intact. This type of procedure may
be referred to as a "gastric stapling"
procedure.
Typically, malabsorptive
procedures result in more weight loss than
restrictive procedures.
Always consult your
physician for more information.
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