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Your doctor will start you on a reduced-calorie diet and a program of regular physical activity. These promote the gradual weight loss that’s healthiest for most people.
But, if they don’t work, your doctor may try another treatment. This is more likely if you’re very obese or have other health problems. These treatments include:
Behavioral therapy
Behavioral therapy involves changing your diet and exercise habits to lose weight.
Strategies for weight loss and maintenance include:
- Check yourself. Keep a daily diary of your food intake and exercise.
- Reward yourself. Give yourself a pat on the back for longer workouts or when you avoid unhealthy eating. But don’t reward yourself with food! Find calorie-free rewards you enjoy, like meeting with friends.
- Be strict, but fair. Your goals should be specific, do-able, and realistic: Don’t say: “I’ll exercise more.” Say: “I’ll exercise for 30 minutes, 5 days a week.”
- Know when you’re full. If you eat more slowly, you’re more likely to hear your body become full. Another trick: Eating more vegetables, which contain fiber, makes you feel fuller.
- Get support. Lean on your family, friends, co-workers, or even a support group, for help. They can encourage your efforts.
Medicines
There’s no magic drug for obesity. But medicine may help some people. Several types of weight loss medicines are approved for use in the US. They include medicines that:
- Curb your appetite.
- Keep your body from absorbing some of the fat in food.
These medicines should be used along with, not instead of, a diet and physical activity program and behavioral therapy. Obesity medicines are usually given only to people who:
- Have a Body Mass Index of at least 30.
- Have a Body Mass Index of at least 27, AND have other obesity-related risk factors or diseases.
In some cases, they may be prescribed to people who have tried diets, exercise, and behavioral therapy, but still haven’t lost weight.
These medicines don’t work for everyone. But experts think weight-loss drugs are modestly effective. Possible side effects include:
- Raised blood pressure or pulse
- Stomach and bowel complaints
Very low-calorie diets
These liquid formulas have about 800 calories. You use them to replace food for a period of weeks or months. Go on this type of diet only if a doctor can monitor you.
If used properly, this diet can take off weight in the short term. Someone who is fairly obese (a body mass index of at least 30) could lose three to five pounds a week on a very low-calorie diet. It can quickly improve obesity-related health problems like:
This type of diet is mostly used for people with a body mass index above 30. But they may be given to people with lower scores who have a weight-related health problem.
Pregnant women and women who are nursing should not go on this type of diet. Nor should most children and teens.
Keep in mind that very low-calorie diets work no better than regular low-calorie diets in the long run. That’s probably because it’s easier to stick with an ordinary low-calorie diet than a very low-calorie diet.
Common complaints of people on very low-calorie diets include:
- Nausea
- Tiredness
- Constipation
- Diarrhea
Surgery
Surgery is the most drastic treatment for obesity. Severe obesity (Body Mass Index of at least 40) is hard to treat through diet and exercise alone. Surgery is an option for severely obese people who can’t shed pounds any other way. It also may be used for very obese people with serious weight-related health problems like diabetes.
Doctors use two types of surgery:
- “Shrinking” the stomach with bands and/or staples. These operations reduce the amount of food you can eat. But they don’t affect digestion. Most people who have this surgery lose some weight. But, by 10 years after surgery, four out of five may have gained back the weight.
- Operations that both reduce food intake and block the body from absorbing calories well. Surgeons remove or wall off much of the stomach. Then they reroute food, so it doesn’t get digested fully. These surgeries are more common than the “shrinking” operations. They also can lead to much greater weight loss. But they can cause nutrient shortages in the long run.
Who can have surgery?
- People with severe obesity (a BMI of at least 40). For men, this means about 100 pounds overweight and for women, about 80 pounds overweight.
- People with a BMI of at least 35 with other serious weight-related health problems, like diabetes, severe obstructive sleep apnea, or heart disease.
Surgery for obesity is not a cure-all. You’ll need to follow a long-term program of diet and physical activity.
Like any medical procedure, obesity surgery has risks. These include infections and other problems linked to the operation itself. Some patients need follow-up operations to deal with complications.
Other risks include gallstones and nutrient shortages. Nutrient shortages usually can be prevented by taking vitamin and mineral supplements.
Also of Interest
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Weight-loss surgery is only for certain special cases, say Obesity Expert Dr. Brunilda Nazario and JaNel. |
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