| The five medically accepted treatment modalities are diet modification, exercise, behavior modification, drug therapy, and surgery. All these modalities, alone or in combination, are capable of inducing weight loss sufficient to produce significant health benefits in many obese individuals. Unfortunately, health benefits are not maintained if weight is regained. With the exception of surgery, it is difficult for most individuals to adhere to these modalities in a manner sufficient to maintain long-term weight loss.
Calorie restriction has remained the cornerstone of the treatment of obesity. The standard dietary recommendations for losing weight include reducing calorie intake by 500 to 1,000 calories a day and having a fat intake of no more than 30% of total calories. Saturated fats should be avoided.
The addition of an exercise program to diet modification results in more weight loss than dieting alone and seems especially helpful in maintaining weight loss and preserving lean body mass. Although vigorous workouts do not immediately burn great numbers of calories, the metabolism remains elevated after exercise. The more strenuous the exercise, the longer the metabolism continues to burn calories before returning to its resting level. Although the calories lost during the postexercise period are not high, over time they may count significantly for maintaining a healthy weight. Included in any regimen should be resistance or strength training 3 or 4 times a week. Even moderate regular exercise helps improve insulin sensitivity and in turn helps prevent heart disease and diabetes. Exercising regularly is critical because it improves psychological well-being, replaces sedentary habits that usually lead to snacking, and may act as a mild appetite suppressant.
Behavior modification for obesity refers to a set of principles and techniques designed to modify eating habits and physical activity. It is most helpful for mildly to moderately obese individuals. One frequently used form of behavior modification called cognitive therapy is very useful in preventing relapse after initial weight loss.
Drug options include anorexiants, which help individuals feel full after eating less food, and a drug that blocks the absorption of fat from the diet. These drugs are adjunctive rather than solo therapy.
Surgery, which carries significant morbidity and mortality, is reserved for well-informed and motivated severely or morbidly obese adults (more than 180% overweight or whose BMI is greater than 40) whose condition has failed to respond to medical weight control. Surgery may also be considered for individuals with less severe obesity (BMI between 35 and 40) who have disabling joint disease, pulmonary insufficiency, hypertension, or diabetes. The most common surgical procedures used to achieve weight loss are gastric bypass and gastric banding. Other procedures include gastroplasty, partial biliopancreatic bypass, and jejunoileal bypass.
Some individuals choose a cosmetic procedure called body contouring, which involves the suctioning of fat and/or the removal of skin from the abdomen, buttocks, and/or thighs. When this procedure is performed on the abdomen, it is called abdominoplasty. |
Source: Medical Disability Advisor