How can I control obesity? | A detailed guide

Obesity is much more than a mere cosmetic concern. It is a complex disease that requires a multi-dimensional approach for treatment. The most alarming fact about obesity is the related morbidities. There is no single specific cause for obesity. However, various risk factors may put you on the brink of obesity. These factors include genetic, age, pregnancy, bad mental health etc. Furthermore, some health issues also play a role as a risk factor for obesity, such as Cushing syndrome, polycystic ovary syndrome (PCOS), Prader-Willi syndrome, hypothyroidism, osteoarthritis etc. similarly, there is no one proven obesity treatment. Instead, there are several strategies to control obesity.

Solution to obesity

For a long, obesity has been the most underrated disease which has been playing havoc worldwide. Alarmingly, obesity was not even considered a disease. It was only in 2013 when American Medical Association accepted obesity as a disease. However, before that, it has been a serious debate if obesity is a disease or a mere cosmetic concern. Since then, weight loss experts are putting significant efforts to control obesity and its treatment as a disease. Following are some of the options for managing obesity and weight loss.

Lifestyle and behavioural changes

Since obesity hasn’t been accepted as a disease so far, lifestyle changes were the best way to prevent and treat obesity. Obesity defines as the accumulation of food that exceeds the body needs. Hence, obesity treatment with a diet plan is a perfect prime solution, and routine exercise is vital to maintain it. Thus, diet plan and weight loss go side by side. Though laparoscopic and bariatric surgery has successfully controlled obesity, lifestyle change and exercise are the most recommended approaches.

Hence, you would need a 300 minutes workout a week. Only a planned diet routine can help you reduce weight and maintain it. Moreover, it helps in improving endurance, strength, and metabolism as well.

Furthermore, obese people who have various emotional disorders need external motivation to keep the medication going on. Hence, addressing both obesity and mental health is vital.

Psychotherapy for weight loss

One of the main leading causes of obesity and weight gain is terrible mental health. Often people suffer from several mental health issues. Consequently, these issues result in disordered eating leading to weight gain and obesity due to

• Anxiety
• Depression
• Emotional overeating
• Bipolar disorder
• Agoraphobia
• Dysthymia
• Hypomanic-episodes

Therefore, it is imperative to control obesity at this level. But, no doubt, healing is a matter of will, and they need the motivation to continue the lifestyle and diet routine. Hence, to treat obesity, it is vital to treat it at the psychological level. Therefore, the psychotherapist helps the patient to continue the course of medicine and the routine.

Control obesity with medicines

Since obesity has been accepted as a disease, there are various pharmacotherapy options available to treat obesity. Calculating the body mass index to weight loss is the first step for diagnosing obesity. Following the diagnosis, the physician recommends the candidate a certain lifestyle change. However, if the diet plan and exercise doesn’t prove to be effective, only then do the physicians move on to pharmacotherapy.

If the BMI turns out to be more than 27 and the candidate suffers from at least one related morbidity, the preferred approach is to control obesity with medicines. The obesity-related morbidities include sleep apnea, gallbladder disease, hyperuricemia, insulin resistance, cardiovascular diseases etc.

There are two main routes for medications to control obesity: restrict fat absorption or limit the appetite. Food and Drug Administration (FDA) has approved the following medicines for weight loss so far.

• Orlistat (Xenical)
• Liraglutide (Saxenda)
• Bupropion/ Naltrexone (Contrave)
• Topiramte/ phentermine (Qsymia)

However, these drugs may have some very unpleasant side effects. For example, orlistat causes frequent and oily bowel movement, gas, bowel urgency etc.

Bariatric surgery

Weight loss surgery is referred to the bariatric surgery. For candidates who suffer from severe obesity, such as with BMI more than 30 and suffer from two or more related morbidities are potential candidates for surgery, especially the patient who fail to control obesity and achieve their weight loss targets described in the section above are subjected to laparoscopic and bariatric surgery for weight loss. Owing to the recent advancements and technological developments, different types of bariatric surgery procedures are now available.

Laparoscopic Roux-Y Gastric Bypass

The bariatric surgeon creates a tiny pouch of your stomach, the size of an egg. Further, the surgeon connects to the small digestive tract. Hence, it restricts the food intake and limits the nutrient absorption to shed off the excess weight.

Laparoscopic Mini Gastric Bypass

Gastric mini bypass focuses on weight loss via malabsorption of the nutrients. The surgeon removes the major portion of the stomach and the upper part of the intestine, the duodenum. However, the pouch is a bit bigger than that in Roux-en Y gastric bypass surgery, approximately 15cm in length. Hence, it restricts bile acid reflux as well.

Laparoscopic sleeve gastrectomy

The procedure to control obesity is also known as vertices sleeve gastrectomy. The surgeon removes two-third of the stomach, and only a banana-shaped stomach is left. The surgery doesn’t target malabsorption but satiety. Due to lesser volume, the person feels fuller with lesser consumption of food and ultimately loses weight.

Surgery proves to be the most efficient for people age between 18 to 65 years. Furthermore, depending upon the type of the surgery, it either limits the food intake or restricts nutrient absorption.

Success rates for bariatric surgery

Despite the cost of bariatric surgery, it has been a promising approach to control obesity. The patient loses approximately 30% to 50% of the excess weight in the first six months after surgery and 77% in further six months. Furthermore, the patient can maintain 50% to 60% loss in the excess weight till 10 to 14 years of the surgery.

Moreover, patients with lower BMI tend to lose more excess weight and achieve the target weight. However, the patients who have Type 2 Diabetes (T2D) lose lesser weight than the people not suffering from T2D. Furthermore, if the patient observes the lifestyle changes such as diet plan and diet routine, the weight loss targets become more achievable.