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 realistic goal of reducing weight by as little as 3% to 5%
of body weight will yield important, positive gains in health.
Treatment goals work best if they are tailored to a person's needs. For example, it
is safe to lose 1 or 2 pounds per week, but a person may be more comfortable losing
at a lower rate of one-half pound per week. Over one year, that is a 26-pound loss.
If that rate is maintained over 3 years, it will lead to a significant weight loss
of 78 pounds. Whatever treatment plan a person follows, losing weight slowly will
be more effective and healthy over the long term. Quick weight loss often spurs weight
Treatment for obesity
Specific treatment for obesity will be determined by your healthcare provider based
Your age, overall health, and medical history
Extent of overweight or obesity
Your tolerance for specific medicines, procedures, or therapies
Your ability to exercise
Expectations for the course of the condition
Your opinion or preference
In addition, treatment for obesity may include a combination of different types of
treatment. Always talk with your healthcare provider for a diagnosis and treatment
There are a variety of methods used to treat obesity. Incorporating multiple methods,
such as making diet changes as well as adding exercise, are beneficial. These methods
include, but are not limited to, the following:
Although diet plans high in protein and fat and low in carbohydrates are popular,
some of these diets 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 time depends
more on limiting energy consumed (calories) and increasing energy expenditure (exercise
and daily activity) than just 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. They may be used for a short time in
people who are obese. Although these liquid diets may be effective in the short term, they
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 choices 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 your 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 a day for women and 1,500 to 1,800
calories a day for men—may work well. A registered dietitian 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 monounsaturated 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
so they do not cause a rapid spike in insulin. This can trigger hunger and cravings.
Choose at least 5 servings daily of fruits and vegetables. Be sure to choose a variety
of fruits and vegetables because 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 (and use it). Avoid
super-size selections when you order. Many restaurant portions are too large for one
person. Consider sharing an entree or ordering an appetizer instead of a main dish
from the entree menu.
Read food labels carefully. Pay particular attention to the number of servings contained
in the product and the serving size. If the label says a serving is 150 calories and
the number of servings per container is 3, the calories are triple, or 450 calories,
if the entire product contents are consumed.
A formal regular exercise program 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. This is because muscle tissue has a higher rate of metabolism, thus burning
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. Increase gradually
to the goal of walking for longer periods most days of the week. If you have severe
arthritis and walking is difficult, water walking in a swimming pool is a very effective
means of exercise. There is minimal weight bearing on the knees with this exercise.
Some fitness centers also offer water aerobics.
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 (the bad cholesterol).
Check with your healthcare provider before starting any exercise program.
A typical day for most U.S. adults all too often involves a sedentary lifestyle. Becoming
active takes effort on your part. Use of the automobile and working at a desk restrict
activity. Watching television is a sedentary activity that can contribute to an inactive
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.
Walk on a treadmill when you watch TV.
Find activities that the whole family will enjoy, such as tennis, in-line skating,
biking, 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. This is 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. Ask your
employer if he or she can allow an exercise program to be built into your work schedule. You
may be able to use a treadmill while you work.
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, psychologists, nutritionists, or exercise therapists. 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 prepared food. Some of these programs
also provide professional consultation to help a person to tailor his or her weight
loss efforts to his or her needs.
Treatment by your healthcare provider may be necessary when an individual's own efforts
to lose weight have failed. And when coexisting medical conditions make it crucial
for a person to lose weight. Medicine may be necessary for those having obesity-related
health problems and, while medicines may help, they are not the "magic" bullet. Behavioral
measures play an even more important part in any weight loss regimen. Behavioral strategies
can be used to help change dietary habits and increase activity levels. Eating disorders
need treatment by a therapist and may also need medicine.
Weight-loss surgery (bariatric surgery) is the only choice today that effectively
treats morbid obesity in people for whom more conservative measures, such as diet,
exercise, and medicine have failed. Potential candidates include:
People 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
People with a BMI between 35 and 40 who have another serious weight-related condition,
such as obesity-related type 2 diabetes, sleep apnea, or heart disease
There are several different types of 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 rerouted 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 or the more aggressive duodenal switch
with biliopancreatic diversion.
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 banding," or vertical sleeve gastrectomy.
Typically, malabsorptive procedures result in more weight loss than restrictive procedures.
They also lead to more nutritional deficiencies.
Always talk with your healthcare provider to find out more information.