The therapeutics of lifestyle management on obesity (original) (raw)

Prevention and Treatment of Obesity - An Over View

Pakistan Journal of Nutrition, 2004

Five major approaches namely dietary, exercise, behavior, combination and pharmacy therapies are used for treatment and control of obesity. In dietary therapy, low-calorie diet (LCD), which provides 800 to 1500 kcal of energy daily; a very-low-calorie diet (VLCD), which provides 250-800 kcal of energy daily and an energy-restricted or hypo caloric diet (HCD), which is based on a person's estimated daily energy requirement. LCDs can reduce total body weight by an average of 8 percent and help reduce abdominal fat content over a period of approximately 6 months. VLCDs are not recommended for weight loss therapy because the deficits are too great, and nutritional inadequacies will occur unless VLCDs are supplemented with vitamins and minerals. Regular exercise/physical activity should be an integral part of weight loss therapy and weight maintenance. A daily regimen of 30-45 minutes of walking, bicycling or working around the house conveys physical activity's positive effects on the muscolo-skeletal, cardiovascular, respiratory and endocrine systems, reduces risk of premature mortality, coronary heart disease, hypertension, colon cancer and diabetes. Exercise should be initiated slowly, and the intensity should be increased gradually; starting from small tasks of daily living such as taking the stairs or walking or swimming at a slow pace leading to the more strenuous activities like brisk walking, cycling, exercise, rope jumping and Jogging. Behavior therapy provides methods for overcoming barriers to compliance with dietary and exercise therapies. Combined intervention of an LCD, increased physical activity, and behavior therapy provides the most successful therapy for weight loss and weight maintenance. Islamic way of life (directional eating) and lifestyle (worship schedule) is the most efficient method for prevention and control of obesity and is one of the best example of combination of diet and exercise therapies. Pharmacotherapy or medication should be the last approach for obesity control.

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...

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...

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.

The Benefit of Healthy Lifestyle in the Era of New Medications to Treat Obesity

Incretin-based medications for treating obesity produce substantial short-and long-term weight loss and improve obesityrelated comorbidities. However, associating lifestyle modification with new medications to treat obesity is generally advisable for several reasons. Firstly, healthy eating patterns and physical activity may offer important additional benefits, enhancing the patient's health and well-being. In addition, regular specialist counselling in lifestyle modification can help patients maintain their motivation levels and develop specific skills for addressing obstacles during the lengthy process of weight loss and maintenance, potentially improving outcomes in the long term. Given the high efficacy of the new weight-loss drugs, it would be timely to streamline and simplify the current gold standard of obesity management based on lifestyle modification. For example, it now seems redundant to prescribe strict diets or meal replacements to reduce calorie intake, or to recommend patients practice 200 to 300 minutes of moderateto-vigorous-intensity exercise for enhanced weight loss. Moderate calorie restriction and, at least 150 minutes of moderate-intensity aerobic exercise and two sessions of muscle-strengthening activities per week may be more achievable and appropriate goals for sustainable weight loss in most patients on pharmaceutical obesity treatment. As regards lifestyle modification counselling, future studies should assess its optimal intensity and duration in the "new medications for obesity era".

A multidisciplinary approach to the treatment of obesity

International Journal of Obesity, 1999

The aim of this paper is: (1) To describe a long-term multidisciplinary group approach to the treatment of morbidly obese persons; and (2) to present, in a preliminary report, results at three months in 30 obese women. Prospective study with evaluation at the start of therapy and after three months of therapy. Thirty obese women, initial mean BMI 35.3 kg/m2, age 28-67 y. Body weight decreased significantly (-6 kg) with 74% of weight loss as fat mass. This moderate decrease in body weight resulted in a significant improvement of VO2max/kg body weight. Resting metabolic rate and metabolic parameters remained unchanged. Among psychological variables, participating in the therapy resulted in a more pronounced restrained eating behaviour, an improvement of body image and a higher expression of positive feelings and actions. Preliminary results of the program are encouraging. However, continuous evaluation and improvement of the program in the long-term (at least several years) are extrem...