How Small Changes in Lifestyle Can Help You Control Obesity and Weight Gain - Health Centre -5AI9.COM

Source: associatedcontent.com Author: Dr. S.C. Mehta Published date: 2008-05-30  

Obesity is a chronic medical condition. Successful treatment employ a multidisciplinary approach to weight loss with hypocaloric diet, physical exercise, behavior modification to change eating habits, social support, and drugs.

Diet Reduced caloric intake play most important role in obesity treatment. A diet rich in fruits, vegetables, whole grains, and other low glycaemic carbohydrates is recommended for promoting weight loss. There is no special advantage to diets restricting carbohydrates and consuming large amount of proteins and fats. Knowledge of the caloric and nutrient content of the food is a valuable aid to weight loss and weight maintenance.

Exercise increases energy expenditure and has a much more positive role in reducing fat storage and weight maintenance.

Behavior modification Patient is requested to monitor and record the circumstances related to eating, and modify behavior leading to change in eating habits. Patients can be taught to recognize `eating cues�Œ ( emotional, situational etc) and how to avoid and control them.

Social Support is essential for a successful weight loss program. Support from family members is essential for reinforcing behavioral changes.

Drugs Carefully controlled diet and physical exercise are the main approaches for any weight loss program, but increasing number of patients may also need medications for obesity. These drugs may act by suppressing food intake, increasing energy expenditure or increasing lipolysis. At present only two drugs are mainly used for weight loss program: Orlistat and Sibutramine.

Orlistat is the first approved medication for obesity. It is a pancreatic lipase inhibitor and thus reduces absorption of fat. In randomized trials with up to 2 years of follow-up orlistat(120 mg) has resulted in modest weight loss (8.7 kg). Side effects include oily stools, flatulence, and cramping.

Sibutramine was originally developed as an antidepressant, found to be effective in the treatment of obesity. Sibutramine acts as an inhibitor of neuronal 5- hydroxytryptamine (5-HT) /noradrenaline reuptake at the hypothalamus that regulate food intake. It reduces food intake and a dose of 10 mg/d results in an average weight loss of 3-5 kg. Side effects include anorexia, dry mouth, constipation and insomnia. In some patients increase in heart rate and blood pressure is reported and the drug is contraindicated in the presence of cardiovascular disease.

Surgery Surgery may be considered as treatment option for patients with severe obesity having a BMI >40 and in whom treatment using diet, exercise and available drugs did not produce adequate response. The beneficial effects of surgery include major weight loss and improvement in hypertension, diabetes, angina, hyperlipidemia, and congestive heart failure. The most popular surgical procedure is roux-en-y gastric bypass (GBP). Operation can be performed by laprotomy or by laproscopy. Another surgical procedure laproscopic adjustable gastric banding is widely used in Europe and can produce substantial weight loss.

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