Treatment
Lifestyle changes
The cornerstone of obesity treatment is making lifestyle modifications, including adopting a healthy diet that is rich in vegetables, fruits, and fibers. Avoiding foods that are high in calories or saturated fats. Also limiting sweets and alcohol intake. It is advised to quit smoking, exercise about half an hour a day, monitor weight regularly, and ensure adequate amount of sleep every night. Changes in lifestyle are necessary to maintain weight loss even when medical or surgical treatment is also pursued.
Cognitive Behavior Therapy (CBT)
In the form of behavioral modification techniques and psychological eating patterns
Medical treatment of obesity:
Antiobesity medications (AOMs) that are commonly used to treat obesity include:
- Appetite suppressants, which reduce feelings of hunger like GLP-I receptor agonists (liraglutide; Semaglutide, tirzepatide)
- Medications that increase metabolism and appetite suppressants, Phentermine, Phentermine combined with Topiramate (Qsymia; VIVUS), Naltrexone combined with Bupropion (Contrave; Currax Pharmaceuticals)
- Medications that block the absorption of fat (Orlistat).
Antiobesity Medications (AOMs) are indicated as an adjunct to caloric restriction and physical activity in adults with a BMI ≥30 kg/m2 or BMI 27 to 29.9 kg/m2 with at least 1 weight-related comorbidity such as diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, nonalcoholic fatty liver disease, or osteoarthritis.
Most of the international medical societies propose that weight loss goals for most individuals with obesity should be ≥10% which lead to greater and more clinically meaningful improvements in weight-related comorbidities, including greater relative risk reduction for diabetes and cardiovascular events, improvements in fatty liver, decreased disease activity in patients with inflammatory rheumatic disease, and improvements in osteoarthritis, obstructive sleep apnea, and cancer risk.
While these medications can be effective in weight loss, they are not recommended for short term use but rather for long term use.
They also have side effects and should only be used under the guidance of a healthcare provider. Note that calorie restricted healthy diets and increased physical activity should always be a part of your treatment plan with antiobesity medications.
Endoscopic treatment includes the following:
- Intragastric balloon: Based on current evidence, balloon therapy is FDA approved as an endoscopic, temporary tool for the management of obesity.
- Endoscopic sleeve gastroplasty: This is a minimally invasive procedure that does not require surgery. It is done through endoscopy under anesthesia. It involves placing stitches in the stomach to reduce the amount of food and liquid the stomach can hold at one time. Endoscopic sleeve gastroplasty leads to significant weight loss.
Internationally approved -Programmed Balloon (Smart Capsule): The patient should be evaluated and made sure that there is nothing to prevent its use. It aims to reduce weight for patients who are overweight or the onset of obesity of the first class.
We recommend against the use of other commercial remedies for obesity that are not FDA approved such as fat burner supplements, Botox injections, or other commercially available treatments that have not been studied in randomized controlled studies for obesity.
