What is the Treatment of Obesity?
There are a number of means of treating obesity. These include dieting, exercise, behavioural therapy, medical therapy and surgery.
What are the Goals and aim of weight management?
Obesity is a chronic condition and its management should be lifelong.Any weight loss should be encouraged and for some, weight maintenance, rather than weight gain, may be a realistic goal.
Is there a medical treatment for obesity?
Yes, In the UK there are two drugs licensed to help in weight reduction.
- Orlistat (which stops fat taken in the diet being absorbed). Orlistat is not absorbed from the gut, and is therefore free from systemic side-effects; however patients eating inappropriate high amounts of dietary fat may experience oily bowel motions, flatulence or leakage.
- Sibutramine (which works as an appetite suppressant). It inhibits reuptake of serotonin and noradrenaline, which control food intake. It has been shown to be an effective aid to weight reduction and maintenance. It is contraindicated in patients with high or poorly controlled blood pressure (>145/90 mmHg) or significant cardiovascular disease. Blood pressure must be checked at 2-weekly intervals for 3 months. Patients must show 2 kg loss at 4 weeks and 5% at 3 months in order to continue treatment.
Both produce modest weight loss but are currently only licensed for up to 2 years use. Like any other medications, they have side effects and patients tend to regain their former weight when they stop taking the medications.
What is the aim of Surgery?
The aim of surgery is to prevent the development of diseases associated with obesity, and to help alleviate them if they are already present. It is not cosmetic surgery, but the treatment of a disease, and the objective is to restore health and quality of life.
Who is suitable for obesity surgery ?
Obesity Surgery, also known as Bariatric Surgery 
is generally indicated in individuals who have a BMI of 40 or 35 with obesity related diseases (comorbidities such as diabetes, arthritis, high blood pressure, etc.), who are motivated to lose weight and had previous meaningful attempts at weight reduction using diet or medications. They should understand the role of surgery and accepts the risks involved and have a low operative & Anaesthetic risks. They should understand the need for follow up. Surgery is recommended as a first-line option (instead of lifestyle interventions or drug treatment) for adults with a BMI of more than 50 kg/m2 in whom surgical intervention is considered appropriate.The aim of surgery is to lose 5-10% of original weight, by focusing on long-term lifestyle changes rather than a short-term, quick-fix approach, addressing both diet and activity, and using a balanced, healthy-eating approach. It is also important to set realistic targets for outcomes other than weight loss, such as increased physical activity, healthy eating.
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