General Practice 2022

Treatment of obesity: diet, medications and surgeries

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Treatment of obesity: diet, medications and surgeries
Treatment of obesity: diet, medications and surgeries
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Obesity treatment can be done with a diet to lose weight and regular practice of physical exercises, or even with the use of medicine indicated by the doctor to help reduce appetite and food compulsion, or, in some cases, bariatric surgery, as it reduces the area of ​​absorption of food by the gastrointestinal tract, which leads to weight loss.

The main objective of these treatments is to achieve and maintain a he althy weight, preventing the development of obesity-related complications such as diabetes, high blood pressure, high cholesterol, gastroesophageal reflux or osteoarthritis, and even impotence or infertility, for example. See all the complications of obesity and how to avoid it.

Obesity treatment should be performed by an endocrinologist or nutrologist and by a multidisciplinary team comprising a nutritionist, bariatrician and physical educator, as more than one type of treatment is usually necessary.In addition, it is important to follow up with a psychologist to identify behaviors that may be causing binge eating or to help not give up on treatment.

The main treatments for obesity recommended by doctors are:

1. Diet changes

The first step, both to treat and to prevent obesity, is to make changes in the diet, including a balanced diet rich in fruits, vegetables, fiber and water, as directed by the doctor and nutritionist.

These dietary changes allow you to control the consumption of calories ingested during the day, which must be lower than what is spent to maintain the body's metabolism, being calculated according to the usual diet, the amount of weight that it is necessary to lose, in addition to age, sex, height and current weight.

Use the calculator to find out how many calories you should eat per day:

Constant long-term weight loss is considered the safest way to lose weight and the best way to keep it off permanently, as drastic changes such as crash dieting or wanting to lose weight too fast can have a quick result, but you will probably regain the weight faster as well. Check out a diet to lose weight in a he althy way.

2. Practicing physical activities

The practice of physical activities, such as walking or swimming, for example, is another essential part of the treatment of obesity, as it helps to increase the body's metabolism, favoring the expenditure of energy and the burning of calories, facilitating the weight loss.

Ideally, in order to lose weight, 150 to 300 minutes of physical activity should be performed per week, being essential to have a medical evaluation before starting the exercises to assess the he alth status, in addition to having the of a physical educator to avoid injuries such as tendinitis or muscle strains, for example.Check out the best exercises to lose weight.

In addition, small changes in lifestyle habits, such as reducing the use of the car or replacing the elevator with stairs, for example, help to move the body more, spend more calories and lose weight. See other ways to move more in everyday life to help treat obesity.

3. Remedies for obesity

The use of medication to treat obesity is indicated by the doctor when the person has a BMI greater than 30kg/m2, BMI greater than 27kg/m 2 and who have other related diseases, such as diabetes, high cholesterol and high blood pressure, and also in cases of people with any type of obesity who cannot lose weight with diet and exercise.

The main remedies indicated for the treatment of obesity are:

  • Appetite suppressants,such as sibutramine, amfepramone or fenproporex, as they act directly on the satiety center in the brain, decreasing appetite, which reduces calorie consumption throughout the day and helps in weight loss;
  • Reducing fat absorption,such as orlistat, which act by inhibiting some enzymes in the intestine, which blocks the absorption of part of the fat from food, reducing the amount of calories ingested per day;
  • CB-1 receptor antagonist,as rimonabant, which acts directly on the brain by inhibiting appetite, increasing satiety and decreasing binge eating;
  • Thermogenics,such as ephedrine, which act by accelerating metabolism causing the body to spend accumulated fat as the main source of energy.

In addition, there are also drugs used to treat other diseases that can help fight obesity, such as antidepressants, and some examples are fluoxetine, sertraline or bupropion.

Medicines for the treatment of obesity should only be used with medical advice, as they require attention and regular monitoring, due to the risk of side effects, such as increased heart rate, increased blood pressure, headache, diarrhea, mood swings, irritability, anxiety or insomnia, for example.

4. Bariatric surgery

Bariatric surgery is indicated by the doctor in cases of morbid obesity, with a BMI greater than 40kg/m2, or moderate obesity, with a BMI greater than 35mg/m 2, in people who have diseases caused by obesity such as diabetes, sleep apnea, high blood pressure, high cholesterol, cardiovascular disease, stroke, arrhythmias or osteoarthritis.

The main types of bariatric surgery are:

  • Gastric band: an adjustable band is placed around the stomach, reducing its size and helping the person eat less. See how gastric band surgery is performed;
  • Gastric bypass: a reduction in the size of the stomach and alteration of the intestine, which is directly connected to the small stomach, which reduces the person's ability to feed on large meals, leading to weight loss. Find out how gastric bypass surgery is performed and how to recover;
  • Biliopancreatic diversion: is done by removing a large part of the stomach and connecting the stomach to the final part of the small intestine;
  • Sleeve gastrectomy or gastric sleeve: the left part of the stomach is removed, which causes a decrease in the stomach's ability to store food. Understand how sleeve gastrectomy surgery is performed.

The type of surgery indicated for each person is decided by the patient together with the gastric surgeon, who evaluates the needs of each person and the procedure that can best suit. Understand better how bariatric surgery is performed and what recovery is like.

Another treatment option is the placement of a temporary intragastric balloon through endoscopy, being indicated as an incentive for some people to reduce food consumption for a period.

Tips for not giving up on treatment

Treatment for obesity is not easy to comply with because it involves changing eating habits and lifestyles that the patient has done throughout life, so some tips to help not give up on treatment can be:

  • Set weekly goals that are possible to achieve;
  • Ask the nutritionist to adjust the diet if it is too difficult to comply;
  • Choose a physical exercise you like, and practice it regularly;
  • Record the results, noting measurements on paper or with weekly photographs.

It is important to remember that there are free weight loss programs, which are carried out by university hospitals with endocrinology services in all states, making it possible to find out about referrals and consultations at the he alth center.

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