Treatment Options for Obesity
Treatment Options for Obesity
(1) MEDICAL /NON-OPERATIVE:
Most of these approaches are based on a low-calorie, low- carbohydrate diet with a combination of behavior modification therapy and exercise. The results of these interventions are not well established in individuals with clinically severe obesity. It is estimated that less than 5% of individuals who participate in such weight loss programs will lose a significant amount of weight and maintain that loss for a long period of time. As a matter of fact, more than 90% of individuals treated this way relapse and regain the weight within two years.
The dismal results of dieting have prompted interest in pharmacological treatment. The most notable and promising weight loss drugs were Fen-Phen; however, its side effects on heart valves led to its withdrawal from the market. Other medications are being used for less severe obesity with some success.
(2) SURGICAL
Surgery has provided durable and sustainable long-term weight loss. Surgical treatment is designed to induce weight loss but can not reverse the underlying causes of obesity. The history of weight loss surgery is very interesting and reflects our evolving understanding of intestinal physiology and long-term side effects. Basically, operations for weight loss can be regarded as 1. restrictive (making the size of the stomach smaller, thus limiting the amount of food intake); 2. malabsorptive (limiting the length of the intestine that comes in contact with food, thus limiting the amount of food absorbed by the body), or 3. a combination of restrictive and malabsorptive.
The most common operation for weight loss in North America is the Roux-en-Y Gastric Bypass (RYGB). We perform the RYGB, which is a combination of restrictive and malabsorptive procedures, because it has
provided superior results. Recently, the Laparoscopic Adjustable Gastric Band, which is a purely restrictive procedure, has been used with modest short-term success. We also perform this procedure.
The National Institute of Health (NIH) recommends weight-loss surgery for those individuals with a BMI ? 40 or a BMI ? 35 with co-morbidities and who can not lose weight by other means.
ADVANTAGES OF SURGERY
Weight loss is not the only reason that weight loss surgery should be undertaken. The more important benefits of surgical treatment are the improvements of general health and quality of life. The following medical conditions are improved or eliminated after weight loss: hypertension, congestive heart failure, diabetes, sleep apnea, asthma, hyperlipidemia, heartburn, arthritis, leg ulcers, etc. A reduction in medications is also noted.
(1) MEDICAL /NON-OPERATIVE:
Most of these approaches are based on a low-calorie, low- carbohydrate diet with a combination of behavior modification therapy and exercise. The results of these interventions are not well established in individuals with clinically severe obesity. It is estimated that less than 5% of individuals who participate in such weight loss programs will lose a significant amount of weight and maintain that loss for a long period of time. As a matter of fact, more than 90% of individuals treated this way relapse and regain the weight within two years.
The dismal results of dieting have prompted interest in pharmacological treatment. The most notable and promising weight loss drugs were Fen-Phen; however, its side effects on heart valves led to its withdrawal from the market. Other medications are being used for less severe obesity with some success.
(2) SURGICAL
Surgery has provided durable and sustainable long-term weight loss. Surgical treatment is designed to induce weight loss but can not reverse the underlying causes of obesity. The history of weight loss surgery is very interesting and reflects our evolving understanding of intestinal physiology and long-term side effects. Basically, operations for weight loss can be regarded as 1. restrictive (making the size of the stomach smaller, thus limiting the amount of food intake); 2. malabsorptive (limiting the length of the intestine that comes in contact with food, thus limiting the amount of food absorbed by the body), or 3. a combination of restrictive and malabsorptive.
The most common operation for weight loss in North America is the Roux-en-Y Gastric Bypass (RYGB). We perform the RYGB, which is a combination of restrictive and malabsorptive procedures, because it has
provided superior results. Recently, the Laparoscopic Adjustable Gastric Band, which is a purely restrictive procedure, has been used with modest short-term success. We also perform this procedure.
The National Institute of Health (NIH) recommends weight-loss surgery for those individuals with a BMI ? 40 or a BMI ? 35 with co-morbidities and who can not lose weight by other means.
ADVANTAGES OF SURGERY
Weight loss is not the only reason that weight loss surgery should be undertaken. The more important benefits of surgical treatment are the improvements of general health and quality of life. The following medical conditions are improved or eliminated after weight loss: hypertension, congestive heart failure, diabetes, sleep apnea, asthma, hyperlipidemia, heartburn, arthritis, leg ulcers, etc. A reduction in medications is also noted.
Tags: Obesity
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