Treatments

At which time is a treatment necessary?

People with a BMI of over 30 should be counseled on diet, exercise and other relevant behavioral interventions.  Also obesity associated diseases like diabetes, heart disease, high blood pressure and joint disorders should be treated by reducing weight.

Goals

Set a realistic goal in combination with slow and steady reduction by making for long periods changes in your eating and physical activity is considered the safest way to lose weight and the best way to keep it off. Reducing one half to one kilo per week should be aspired. Too rapid weight loss can cause developing other problems, such as gallstones and nutrient deficiencies. An unwanted reaction of the body is the so called jojo effect that means reducing weight too fast is leading to regain your old body weight because of changing in utilization the nutrition.

Main treatment

The main treatment for obesity consists of eating less, exercising more and behavior therapy. Diet programs may produce weight loss over the short term, but keeping this weight off can be very difficult. Consulting by a dietician and practitioner should be aspired.

1.)    Dietary therapy: Dietary therapy implicates individual instruction on how to adjust a diet to reduce the number of ingested calories. Reducing calories moderately is essential to lose weight or maintain weight. Strategies of dietary therapy include teaching about calorie content of different foods, food composition and how to prepare foods.

2.)    Physical exercises: Physical exercises for 30 to 45 minutes, 3 to 5 day a week should be an integral part of weight loss therapy and weight maintenance. Initial activities may be increasing small tasks of daily living such as taking the stairs or walking. In addition, physical activity is conducive for reducing risks for cardiovascular disease and diabetes type 2, beyond that produced by weight reduction alone. To decide which individual activity should be chosen a consultation with a practitioner is very important.

3.)    Behavior therapy: Individualizing behavior therapy provides methods for overcoming barriers to compliance with dietary therapy and increased physical activity. These Methods are essential components of weight loss treatment. Element of the behavior therapy are developing a social support network consists of family, friends and colleagues, incorporating patient's attitudes, belief and history, including partnership with the healthcare provider, self-monitoring, stress management and setting reasonable goals.

Drugs

If there is no response in dieting and physical exercises drugs may be used as adjuvant therapy. Because of side effects and contraindications drugs should received only with physicians agreement.

Weight loss surgery

Weight loss surgery or bariatric surgery should be reserved for patients with a BMI of 40 or more or a BMI of 35 and other health problems related to the weight if other methods of treatment have failed. There are two major types of bariatric surgery. On the one hand the restrictive operation e.g. gastric banding to reduce food intake by narrowing the passage between the upper and the lower part of the stomach. On the other hand the Roux-en-y gastric bypass which makes the stomach smaller and allowing food to bypass a part of the small intestine. In addition to usual surgery complications there are some effects which should considered. After surgery patients have to drink or to eat in very small amounts and have to follow the instructions to maintain an adequate intake of vitamins.