A statistic frequently used
about obesity treatment is that 95 percent of
people who lose weight gain it all back. That
statistic, based on a small study from 1959, is
no longer valid. Much has changed in the way of
obesity treatment since then. Thousands of
people have succeeded in losing weight and
keeping it off -- an encouraging fact for many
that are discouraged by outdated information.
There are several different types of effective
treatment options to manage weight including:
dietary therapy, physical activity, behavior
therapy, drug therapy, combined therapy and
Weight loss of about 10 percent
of excess body weight is proven to benefit
health by reducing many obesity-related risk
factors. Recommendations for treatment are now
focusing on 10 percent weight loss to help
patients with long-term maintenance of weight
loss. Health professionals including physicians,
nutritionists, exercise physiologists,
psychologists and bariatric surgeons help
persons with overweight and obesity to determine
the most appropriate treatment.
Dietary therapy involves
instruction on how to adjust a diet to
reduce the number of calories eaten.
moderately is essential to achieve a slow
but steady weight loss, which is also
important for maintenance of weight loss.
Strategies of dietary
therapy include teaching about calorie
content of different foods, food
composition (fats, carbohydrates, and
proteins), reading nutrition labels, types
of foods to buy, and how to prepare foods.
Some diets for weight loss
include low-calorie, very-low calorie, and
A decrease in the amount of
daily activity related to work,
transportation and personal chores is
believed to contribute to the high
percentage of overweight and obesity today.
Moderate physical activity,
progressing to 30 minutes or more on most
or preferably all days of the week is
recommended for weight loss.
Physical activity is
reported to be a key part of maintaining
Abdominal fat, and in some
cases waist circumference can be modestly
reduced through physical activity.
Strategies of physical
activity include: the use of aerobic
exercise (such as aerobic dancing, brisk
walking, jogging, cycling, and swimming),
beginning slowly and gradually increasing
intensity, and selecting enjoyable
activities that can be scheduled into a
Behavior therapy involves
changing diet and physical activity
patterns and habits to new behaviors that
promote weight loss.
strategies for weight loss and maintenance
Recording diet and
exercise patterns in a diary.
situations (such as having
high-calorie foods in the house), and
consciously avoiding them.
actions, such as exercising for a
longer time or eating less of a
certain type of food.
goals and false beliefs about weight
loss and body image to realistic and
Developing a social
support network (family, friends or
colleagues) or joining a support group
that can encourage weight loss in a
positive and motivating manner.
Drug therapy is recommended
as a treatment option for persons with: 1)
a Body Mass Index (BMI) > 30 with no
obesity-related conditions or 2) a BMI of
> 27 with two or more
Drug treatment should be
used with appropriate lifestyle
Drug therapy may be used
for weight loss and weight maintenance.
Patients should be
regularly assessed to determine the effect
and continuing safety of a drug.
Three weight loss drugs,
approved by the US Food and Drug
Administration (FDA) for treating obesity,
are Orlistat (Xenical), Phentermine, and
Orlistat works by
blocking about 30 percent of dietary
fat from being absorbed, and is the
most recently approved weight loss
appetite suppressant, has been
available for many years. It is half
of the “fen-phen” combination that
remains available for use. The use of
phentermine alone has not been
associated with the adverse health
effects of the
Sibutramine is an
appetite suppressant approved for
A combination of a diet
(with lower calories) and increased
physical activity is reported to produce
more weight loss than diet alone or
physical activity alone.
A combination of behavior
therapy and drug therapy could prove to be
an effective treatment for obesity.
Drug therapy appears to
assist in the adherence to dietary therapy
(low-fat, low-calorie diet), and may
improve maintenance of weight loss.
Obesity surgery is
recommended as a treatment option for
persons with obesity that have: 1) a BMI
> 40 or 2) a BMI of 35 to 39.9 with
serious medical conditions.
Obesity surgery is used to
modify the stomach and or intestines to
reduce the amount of food that can be
Surgery is a
well-established method for long-term
weight control for persons with severe
Much progress has been made
to develop safer and more effective
procedures used in obesity surgery today.
Before surgery, patients
should be informed about the risks and
Patients should be
motivated and committed to making a
lifestyle change after surgery.
A medical team, including
behavioral and nutritional professionals,
should be part of a life-long follow-up