Obesity and its treatment (original) (raw)
Obesity – A global Burden, Crucial Problem for the Society
Bangladesh Journal of Medicine, 2018
Objectives: To aware doctors, patients, food producers and consumers. Data source: Online search via Google, 70 articles were down loaded, 52 valid papers were selected. Only 12 full text articles were eligible for review. Obesity rates have increased sharply over the past 30 years, creating a global public health crisis. The impact of obesity on morbidity, mortality, and health care costs is profound. Obesity and weight related complications exert a huge burden on patient suffering and social costs. In recent years, exciting advances have occurred in all 3 modalities used to treat obesity: lifestyle intervention, pharmacotherapy, and weight-loss procedures including bariatric surgery. Obese individuals lose approximately 6 to 8 kg (approximately 6% to 8% of initial weight) with 6 months of participation in a high-intensity lifestyle intervention ($ 14 treatment visits) consisting of diet, physical activity, and behavior therapy. Such losses reduce progression to type 2 diabetes in at-risk people and decrease blood pressure and triglyceride levels. All diets, regardless of macronutrient composition, can produce clinically meaningful weight loss (.5%) if they induce a deficit of 500 kcal/d. Physical activity of 150 to 180 min/week yields modest short-term weight loss compared with diet but contributes to improvements in obesity-related conditions. Gradual weight regain is common after lifestyle intervention but can be prevented by continued participation in monthly weight loss maintenance sessions, as well as by high levels of physical activity (ie, 200 to 300min/wk). Patients unable to reduce satisfactorily with lifestyle intervention may be candidates for pharmacotherapy, recommended as an adjunct. Five medications have been approved by the US Food and Drug Administration for chronic weight management, and each has its own risk/benefit profile. The addition of these medications to lifestyle intervention increases mean weight loss by 2.5 to 8.9 kg compared with placebo. Patients with severe obesity who are unable to reduce successfully with lifestyle intervention and pharmacotherapy are eligible for bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, or adjustable gastric banding.
Disease Burden, Mechanism and Management of Obesity – Where Do We Stand?
Journal of Interdisciplinary Medicine
The role of increased body mass index in general morbidity and mortality is well documented. This global public health issue continues to represent a major burden and threat to health systems and the population’s wellbeing. Global statistics show that the prevalence of obesity has increased about three times since the mid-1970s, and an upward trend is still observed, not only in developed but also in developing countries. We used several databases, including PubMed, ProQuest, and Google Scholar, to perform a literature search and review on obesity. Keywords such as “obesity”, “overweight”, and “BMI” were used in combination with multiple keywords such as “mechanism”, “factors”, “socio-economic”, “environmental”, “social determinants”, “management”, “treatment”, “non-traditional treatment”, “alternative therapies”, “non-pharmaceutical treatment” etc. and related phrases. According to the literature, the management of obesity is difficult due to the complex nature of this problem in t...
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...
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.
Obesity, A Threat to Global Health: A Review
https://www.ijrrjournal.com/IJRR\_Vol.7\_Issue.9\_Sep2020/Abstract\_IJRR0038.html, 2020
Obesity is one of the most serious life threatening health problems of the 21st century which affects nearly 300 million people worldwide that in turn would trigger additional pathologies such as cardiorespiratory dysfunctions, cancer, gastrointestinal disturbances, and type2 diabetes mellitus. Obesity has a multifactorial nature resulting from genetic, physiological, behavioural, and environmental factors that lead to an imbalance between energy intake and expenditure. However, the key to success in tackling this problem lies in prevention and this in itself mandates a rigorous understanding of the physiology of weight control and the pathogenesis of obesity. Conventional therapies such as lifestyle modification (diet and exercise) recommended as the cornerstone of obesity management. The Food and Drug Administration (FDA) has approved five long-term obesity drugs for adults who are obese so far: orlistat, lorcaserin, liraglutide, phentermine/ topiramate, and naltrexone/ bupropion over the past two years. When treating an obese patient for any given disease, several physiological changes may impact the pharmacokinetic properties of the drugs required. Therefore, pharmacotherapy remains important but is limited by their results in terms of weight loss. Additionally, several medical devices are available for short-term and long-term use. Bariatric and metabolic surgical interventions (gastric banding, sleeve gastrectomy, and Roux-en Y gastric bypass) are endorsed by many international societies to be an effective treatment for weight loss, which also offers significant improvement in associated comorbidities and reduce mortality for patients with severe obesity.
The prevention and treatment of obesity
Deutsches Ärzteblatt international, 2014
The high prevalence of obesity (24% of the adult population) and its adverse effects on health call for effective prevention and treatment. Pertinent articles were retrieved by a systematic literature search for the period 2005 to 2012. A total of 4495 abstracts were examined. 119 publications were analyzed, and recommendations were issued in a structured consensus procedure by an interdisciplinary committee with the participation of ten medical specialty societies. Obesity (body-mass index [BMI] ge;30 kg/m2) is considered to be a chronic disease. Its prevention is especially important. For obese persons, it is recommended that a diet with an energy deficit of 500 kcal/day and a low energy density should be instituted for the purpose of weight loss and stabilization of a lower weight. The relative proportion of macronutrients is of secondary importance for weight loss. If the BMI exceeds 30 kg/m2, formula products can be used for a limited time. More physical exercise in everyday li...
Obesity: A Real Global Health Concern
Obesity, also known as the new world syndrome, is a fast emerging health problem, multi-factorial in nature and is associated with various significant diseases like hypertension and other cardiovascular diseases, type-2 diabetes, obstructive sleep apneas, osteoarthritis and few cancers. The management of obesity requires a range of strategies for individuals with existing obesity and also for those who are at high risk of developing obesity. This short review highlights the role of lifestyle modification which has now become the initial approach for the management of obesity, overweight and many other associated diseases.
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.
Obesity: Treatments, Conceptualizations, and Future Directions for a Growing Problem
Biology, 2022
Interventions in obesity management include nutritional selection, diet restriction, and physical exercise, followed by cognitive behavioral strategies, pharmacology, and surgery towards the tapered treatment end of the obesity pyramid of interventions. Calorie restriction, regular exercise, and several weight reducing drugs, including probiotic and prebiotic use, are increasing in the market as potential anti-obesity treatments all over the world. Despite these efforts, obesity is increasing and is at epidemic levels. We propose here that there should be a multicomponent individual specific treatment approach for treating this multifactorial pathogenesis, incorporating psychological assessment as a first step that may help to reduce the prevalence of this alarming epidemic. We also believe that focusing on psychological screening may not be enough to control this epidemic without government and community cooperation and intervention. Additionally, we suggest that it is imperative t...
The Global Burden of Obesity and the Challenges of Prevention
Annals of Nutrition and Metabolism, 2015
The prevalence of obesity is increasing at an alarming rate in many parts of the world. About 2 billion people are overweight and one third of them obese. The plight of the most affected populations, like those in high-income countries in North America, Australasia and Europe, has been well publicized. However, the more recent increases in population obesity in low- and middle-income countries that are now increasingly being observed have been less recognized. Based on the existing prevalence and trend data and the epidemiological evidence linking obesity with a range of physical and psychosocial health conditions, it is reasonable to describe obesity as a public health crisis that severely impairs the health and quality of life of people and adds considerably to national health-care budgets. Intersectoral action to manage and prevent obesity is urgently required to reverse current trends.
Management of Obesity in the National Health and Nutrition Examination Survey (NHANES), 2007–2008
Annals of Epidemiology, 2012
Introduction: The prevalence of obesity has been increasing in the United States. We set out to investigate the use of anti-obesity drugs in recent years. Methods: We included 2630 men, and 2702 women who took part in NHANES. We analyzed their demographic, and anthropometric data, and their weight, and drug history. A person is a candidate for treatment of obesity if the initial body mass index ≥ 30 kg/m 2 , or ≥ 27 kg/m 2 in the presence of other risk factors (e.g. hypertension, diabetes or dyslipidemia). Sampling weights were used to adjust for non-response bias, and the oversampling of blacks, Mexican Americans, and the elderly. Results: 45.9% of men, and 45.0% of women were candidates for treatment. Among these participants, 85.1% considered themselves overweight, 90.1% would like to lose weight, 61.9% had dietary changes, 36.5% exercised, 3.7% took non-prescription diet pills and 2.2% took prescription diet pills to control weight during the preceding year. During the preceding month, 0.5%, and 0.1% of participants were taking phentermine, and orlistat respectively. There were no participants on sibutramine. Conclusions: Obesity is highly prevalent in the United States, but only a very small percentage is on anti-obesity medication. The withdrawal of sibutramine in October 2010 would have minimal impact on the general population. While improvements in pharmacological treatment of obesity are needed, our study also revealed that there is a need for more lifestyle changes in the majority of obese individuals.
Lancet (London, England), 2016
A modern approach to obesity acknowledges the multifactorial determinants of weight gain and the health benefits to be derived from weight loss. Foundational to any weight loss effort is lifestyle change, diet, and increased physical activity. The approach should be a high quality diet to which patients will adhere accompanied by an exercise prescription describing frequency, intensity, type, and time with a minimum of 150 min moderate weekly activity. For patients who struggle with weight loss and who would receive health benefit from weight loss, management of medications that are contributing to weight gain and use of approved medications for chronic weight management along with lifestyle changes are appropriate. Medications approved in the USA or European Union are orlistat, naltrexone/bupropion, and liraglutide; in the USA, lorcaserin and phentermine/topiramate are also available. Surgical management (gastric banding, sleeve gastrectomy, and Roux-en Y gastric bypass) can produc...
Obesity as a Growing Public Health Problem
Adiposity - Epidemiology and Treatment Modalities, 2017
Obesity is one of the most important reasons for reduced life expectancy within the "modern" world. The prevalence of overweight and obesity continues to increase both in developing and in developed countries. It is common in every age group, from pediatric to geriatric individuals, which serve as our future and heritage in the universe. It was clearly seen in reported studies around the world that overweight and obesity are still growing epidemic health problems. It is well known that obesity results in impaired health and premature death. Obesity does not only impair the physical and mental health of people but also impairs economic wealth of most communities. The heavy burden of treatment cost and reductions in effective labor power leads to financial losses all over the world. Obesity has a higher morbidity rate than diseases emanating from underweight. Primarily, we have to find a reasonable and sustainable solution to this problem, in order to reach the longer life expectancy and more qualified life span in the twenty-first century. The policy makers in health services and health professionals in medicine have important roles to prevent and cure this "contemporary" epidemic. Additionally, the most crucial step for people is to get rid of the prevailing inertia and take personal responsibility for their health development.