Obesity: Treatments, Conceptualizations, and Future Directions for a Growing Problem (original) (raw)
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Treatment Modalities of Obesity
Diabetes Care, 2008
The prevalence of obesity is increasing in both developed and developing countries, with rates reaching ∼10–35% among adults in the Euro-American region. Obesity is associated with increased risks of cardiovascular diseases, type 2 diabetes, arthritis, and some type of cancers. Obesity significantly affects the quality of life and reduces the average life expectancy. The effective treatment of obesity should address both the medical and the social burden of this disease. Obesity needs to be treated within the health care system as any other complex disease, with empathy and without prejudice. Both health care providers and patients should know that the obesity treatment is a lifelong task. They should also set realistic goals before starting the treatment, whereas keeping in mind that even a modest weight loss of 5–15% significantly reduces obesity-related health risks. Essential treatment of obesity includes low-calorie low-fat diets, increased physical activity, and strategies con...
Behavioral and medical management of obesity
South Dakota medicine : the journal of the South Dakota State Medical Association, 2011
South Dakota physicians are confronted by an epidemic of obesity. Developing an effective management strategy for patients with this condition can be daunting. This article reviews the evidence behind dietary, exercise-based, and pharmacological approaches to the care of the overweight and obese patient, offering recommendations to the clinician based on this evidence.
The Journal of Nutritional Biochemistry, 1998
Obesity is epidemic in America. About 80 million Americans are obese, 33.4% of adults and about 20% to 25% of children. Obesity produces morbidity and mortality: there are 300,000 obesity-related deaths annually in America. The definition of obesity has not been standard. Recently, the World Health Organization defined overweight as a body mass index (BMI ϭ kg/m 2) of 25 and obesity as a BMI of Ն30. A BMI of Ն35 produces a high risk from obesity and of Ն40 produces a severe risk. The presence of complications of obesity (hypertension, diabetes, dyslipidemia, sleep apnea, etc.) increases the risk. Treatments of obesity depend on the severity of obesity, the presence of complications, and the absence of exclusions. Exclusions from obesity treatment include pregnancy, lactation, terminal illness, major mental illness, anorexia nervosa. Eating disorders and major medical disorders are strong cautions for obesity treatment. Obesity with a low or modest health risk (BMI: 25-30) is best treated with a diet lower in calories and fat than the current diet, exercise, and lifestyle modification. With obesity that produces a moderate to high health risk (BMI: 30-35), the above treatments plus a very low calorie diet or obesity drugs may be indicated. High and very high health risk due to obesity may be treated with the above regimen plus obesity surgery. In every category of obesity, the presence of complications of obesity increases the risk and justifies more aggressive forms of treatment. Treatment of obesity with drugs has gained acceptance in recent years. There are no absolute indications for drug treatment. Contraindications include pregnancy and lactation, unstable cardiac disease, uncontrolled hypertension, severe psychiatric disorder or anorexia, and other drug therapy, if incompatible. Cautions include the presence of any severe systemic illness and certain other problems such as closed angle glaucoma. Obesity surgery is reserved as a last resort. Contraindications to surgery and significant mental or physical diseases preclude obesity surgery. Whatever the form of treatment, individualized attention with careful follow-up is mandatory. Obesity is similar to other chronic diseases; if the treatment stops, the disease comes back.
Recommendations For The Management of Obesity
Medicine Science | International Medical Journal, 2014
Obesity, which results from an imbalance between energy intake and expenditure, is one of the most important health issues of our day, and is associated with many diseases such as type 2 diabetes, coronary artery disease, increased cancer risk, osteoarthritis, and obstructive sleep apnea syndrome. Achieving long-term weight management in the course of obesity treatment is not possible as long as significant changes in life style are not implemented. In this manuscript, we present a simple and feasible treatment model that we employ in the management of obesity.
A Case for Incorporating Obesity into the DSM
Obesity is excess adipose tissue resulting from disproportionate energy intake and expenditure. Current trends indicate a crisis of overweight and obesity (OW/OB) worldwide. The International Statistical-Classification of Diseases and Related Health Problems employs an energy model of overweight, hence professional interventions include appetite suppressors, lifelong pharmaceuticals and bariatric operations. These have been largely inefficacious, since individuals do have underlying cognitive and emotional drivers for consumption. Dietary restrictions may produce preoccupation with food, and nutritional counselling and behavioural therapy inefficaciously alter eating habits. Thus, an alternative perspective on obesity’s causal framework, particularly via a psychological component, is important in obesity reduction. In explicating this perspective, this paper concludes that obesity should be introduced into the fifth edition of the Diagnostic and Statistical Manual (DSM-5; American Psychiatric Association, 2013). Obesity was demonstrated to have a strong psychological, behavioural and neurobiological component. The neuropsychological correlates between obesity and substance addiction were examined; the paper concluded that the addictiveness of eating may operate through heightening reward value of pleasant food via reward pathways because of repeated hypothalamic pituitary adrenal axis activation. Finally, a comparison of the criteria utilised to exclude another syndrome, Internet Addiction (IA), was used to further support incorporating obesity into the DSM-5. This is because obesity met the inclusion criteria which involved a theoretical grasp within the literature of the etiology and pathophysiology underpinning obesity.