PreventionTo prevent obesity and maintain a healthy body weight throughout life, eat a well-balanced diet and exercise regularly. Preventing obesity is important because once fat cells form, they remain in your body forever. Although you can reduce the size of fat cells, you cannot get rid of them.
TreatmentWeight reduction is achieved by consuming fewer calories and increasing activity and exercise.
Structured approaches and therapies to reduce weight include :
- A modified diet. A reasonable weight loss goal is 1 to 2 pounds weekly, which can usually be achieved by eating 500 to 1,000 fewer calories daily. Whether you concentrate on eating less fat or fewer carbohydrates is a matter of personal choice. Fats have more than twice as many calories per ounce than carbohydrates or protein. If you cut out carbohydrates, you still need to limit fat and choose healthy fats, such as monosaturated and polyunsaturated oils.
- Regular exercise. To effectively lose weight, most people need to do moderate intensity exercise for 60 minutes most days of the week. Add more activity during the day by taking the stairs and getting up often from your desk or sofa.
- Non-prescription orlistat (Alli). Orlistat inhibits fat absorption in the intestine by binding to a digestive enzyme called lipase. Until recently, this medication was only available by prescription (known as Xenical). The over-the-counter medicine is sold at a lower dose than Xenical but the active ingredient is exactly the same.
- Other non-prescription diet pills. In general, over-the-counter diet pills contain ingredients that can increase heart rate and blood pressure. It is not clear how effective they are in producing weight loss that can be maintained over time. Common side effects include feeling jittery and nervous and having heart palpitations. Over-the-counter diet pills containing phenylpropanolamine have been taken off the market because this ingredient is associated with an increased risk of stroke. Diet pills with other ingredients also may elevate blood pressure, and some experts believe they may be associated with an increased risk of stroke.
- Prescription diet pills. These include orlistat (Xenical), which decreases the absorption of dietary fat by 30%; amphetamine derivatives; and sibutramine (Meridia). To help you lose weight, your doctor may prescribe medications along with a calorie-restricted diet. However, almost all people regain weight when they stop using these medications. The effects of long-term use of these drugs have not been determined.
- Surgery. If obesity is severe (a BMI greater than 40), your doctor may recommend a surgical procedure to limit the amount of food your body can digest. One procedure is called gastroplasty, also known as stomach stapling. A surgeon creates a small pouch in the stomach that allows only limited amounts of food to be eaten at one time. Recently stomach banding has become quite popular. This procedure can be done using a laparoscope rather than making a larger surgical incision needed for gastroplasty.
When to Call a ProfessionalCall your doctor if you need help losing weight or if you have any of the symptoms or complications of
obesity.
PrognosisSome people are successful at losing weight and keeping it off. Others, however, find it difficult to maintain the weight loss for long. Most people return to their pretreatment weight within five years.
