There are multiple treatment options available for managing obesity. This is due to an estimate of 60% of the US population suffering from some degree of obesity. Before exploring options, a baseline assessment of nutritional and medical status should be complete. There is an increased risk of diabetes, hypertension, and cardiovascular disease in patients who suffer from obesity. Other risk factors include an increased risk of liver cancer, colon cancer, and pancreatic cancer.
Before you explore treatment options, you should receive an evaluation by a gastroenterologist. NAFLD (fatty liver) is now the most common cause of end-stage liver disease in the U.S. This disease occurs in the pediatric age group as well as young adults. Since the findings on laboratory evaluations and physical examination are often very subtle. Again, a consultation with a gastroenterologist would be helpful.
Treatment Options & Food Plans
Specific options for the treatment of weight loss include the following: lifestyle modifications, medications, and bariatric surgery. The cornerstone of any treatment regimen is caloric restriction and exercise. Calorie restriction of 1200-15000 calories per day is essential to managing your weight. Most patients who do not lose weight with intake restrictions are underestimating calorie intake.
Food plans are a highly effective method for maintaining and improving weight loss. To ensure your food plan is as effective a possible, you should weigh and measure your food intake. Four ounces of chicken after cooking is about 2 good bites. Although multiple different diets have been promoted, no one diet has been found to be superior. There are no studies that suggest the keto diet is better than the Mediterranean and vice versa.
Whatever diet you chose, it has to be palatable. Since calorie restriction is indefinite, the diet also has to be something reasonably sustainable. In addition to calorie restriction, weekly physical exercise is essential. 150 hours a week of aerobic exercise plus resistance training is just one of many options for physical exercise. It should be noted that exercise alone will not result in significant weight loss. However, it will help maintain weight loss.
Managing Obesity with Medication
Several different medications have been FDA approved for weight loss. This includes phentermine, orlistat, naltrexone/bupropion, and liraglutide. The choice of drug therapy is a balance between efficacy, adverse effects, and patients’ other medical problems. Consulting with a nutritionist and gastroenterologist will help determine the best option for you. If 5% or more weight loss doesn’t occur within three months, you should discontinue your medication.
The last option is bariatric surgery. Gastric balloons have become increasingly popular and offer varying success. Gastric balloons can result in obstruction, gastric ulcerations, and abdominal pain. Endoscopic remodeling results in a type of restrictive surgery with varying degrees of success.
With that in mind, bariatric surgery is an option strictly for patients with a BMI greater than 40 or over 35 with medical problems associated with obesity. Two operations are commonly available; the gastric sleeve and the Roux-en-y. The gastric sleeve removes a portion of the stomach, while the Roux-en-y gastric bypass is more invasive with a 12% complication rate. Although there is a higher complication rate, it results in a significantly higher weight loss.
Obesity is a national epidemic affecting all age groups and genders. Aggressive lifestyle medication associated with calorie restriction is the basis of any program. An aggressive approach with a consultation should be considered. Consult with Dr. James Maher today to learn the best option for you.