Medical treatments for obesity

Medical treatments for obesity

More and more experts say that the main goal of treatment should be toadopt from better lifestyle. Thus, present and future health is improved. Rather, the weight loss that can ensue should be viewed as a “side effect”.

A global approach

The most effective approach to improving long-term health is personalized, multidisciplinary and requires regular follow-up. The therapeutic approach should ideally include the services of the following professionals: a doctor, for an dietitian, for an kinesiologist and one psychologist.

We must start with a checkup established by a doctor. Consultations with other health professionals follow. It is better to bet on a follow-up over several years, even during the weight maintenance phase. Unfortunately, few clinics offer such support.

According to experts at the Mayo Clinic in the United States, a weight loss corresponding to 5% to 10% of body weight significantly improves health19. For example, for a person weighing 90 kilos, or 200 pounds (and being obese according to their body mass index), this corresponds to a weight loss of 4 to 10 kilos (10 to 20 pounds).

Weight loss diets: to be avoided

Most weight loss diets are ineffective at long-term weight loss, in addition to being risky, studies say4,18. Here are some possible consequences:

  • long-term weight gain: the calorie restriction imposed by diets is often untenable and generates intense physical and psychological stress. In a state of deprivation, theappetite increases and energy expenditure decreases.

    After analyzing 31 studies from the United States and Europe, researchers observed that there may be weight loss in the first 6 months of a diet4. However, from 2 to 5 years later, up to two-thirds of people regained every weight lost and even gained a few more.

  • dietary imbalances: According to a report published by the National Health Security Agency of France, following a weight loss diet without the advice of a specialist can lead to nutrient deficiencies or, even, excess55. Experts have studied the effect of the 15 popular diets (including Atkins, Weight Watchers and Montignac).

 

Food

With the help of a dietitian-nutritionist, it’s about finding a nutritional approach that suits our own tastes and lifestyle, and learning to decipher our eating behaviors.

On this subject, see two articles written by our nutritionist, Hélène Baribeau:

Weight problems – obesity and overweight: adopt new lifestyle habits.

Weight problems – obesity and overweight: dietary recommendations and menus to lose weight.

Physical activity

Increase its energy expenditure helps a lot in weight loss and in improving general health. It is safer to consult a kinesiologist before starting any physical activity. Together you will be able to choose a training program appropriate to your physical condition and interests.

Psychotherapy

Consult a psychologist or a psychotherapist can help to understand the origin of the excess weight, change certain eating behaviors, cope better with stress and regain self-esteem, etc. Consult our Psychotherapy sheet.

pharmaceuticals

Some pharmaceuticals obtained with a prescription can help with weight loss. They are reserved for people who have significant risk factors for cardiovascular disease, diabetes, hypertension, etc. These drugs cause modest weight loss (2,6 kg to 4,8 kg). We must continue to take them for the effect to remain. In addition, they must be associated with a strict diet and have several contraindications.

  • Orlistat (Xenical®). The effect is a reduction in the absorption of dietary fat by about 30%. Undigested fat is excreted in the stool. It should be accompanied by a low fat diet to avoid or reduce side effects.

    Common side effects: watery and oily stools, urge to have a bowel movement, gas, abdominal pain.

    Note. In the United States and Europe, orlistat is also available over the counter at half the strength, under the trade name There® (in France, the drug is stored behind the pharmacist’s counter). The drug Alli® is intended for overweight people. It can cause the same types of side effects as Xenical®. It should also be accompanied by a low fat diet. Contraindications apply. It is recommended to consult a doctor before starting treatment with this drug in order to obtain a health check and a comprehensive approach to weight control.

 

Note that the Meridia® (sibutramine), an appetite suppressant, has been discontinued in Canada since October 2010. This is a voluntary withdrawal by the manufacturer, following discussions with Health Canada56. This medicine increases the risk of myocardial infarction and stroke in some people.

 

surgery

La bariatric surgery most often consists of reducing stomach size, which reduces food intake by about 40%. It is reserved for people who suffer frommorbid obesity, that is, those with a body mass index over 40, and those with a BMI over 35 who have an obesity-related disease.

Notes. Liposuction is cosmetic surgery and should not be used for weight loss, according to experts at the Mayo Clinic in the United States.

 

Some immediate benefits of weight loss

  • Less shortness of breath and sweat on exertion;
  • Less painful joints;
  • More energy and flexibility.

 

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