How can obesity be treated?

Expert opinion:

There is no single effective treatment for long-term weight loss. Lifestyle changes underly all currently effective treatments and should be emphasised.1

Some of the findings from a major report produced by the National Health and Medical Research Council (NHMRC) are shown.  These findings need to be read together with the full report published by the NHMRC which is easily available online (see reference below).

Surgical options

Expert opinion:

  • Surgery—mainly of the types that restrict the intake or absorption of food—is the most effective weight-loss treatment in severely obese patients2
  •  Surgically induced weight loss results in a marked reduction in some of the co-morbidities (other illnesses) associated with obesity (particularly diabetes) and an improvement in quality of life
  • Although it may appear expensive relative to other treatments obesity surgery is one of the most cost-effective treatments available.2

There are three main types of weight loss (or bariatric) surgery conducted in Australia.  These are:

  1. Gastric bypass
  2. Non-adjustable gastroplasty
  3. Adjustable gastric banding (the LAP-BAND® System)

 

What are the conventional treatments?

There are a number of conventional treatments that can be used:

  • Diet
  • Exercise
  • Diet and exercise in combination
  • Behavioural therapy
  • Pharmacology (medications including phentermine, diethylpropion, orlistat and sibutramine) 

 

Possible results if treatment is not considered are detailed below:

Weight loss Duration of follow-up
Diet and Lifestyle 5 kg 2-4 years
Drug therapy 5-10 kg 1-2 years
Surgery 25-75 kg 2-4 years

 

 

Conventional treatments are only moderately effective for long term weight loss

Treatment Weight loss/gain over 1-2 years Weight loss/gain over 2 years Ability to prevent weight regain?
No treatment Average loss 0.2kg Average gain 1.9kg over 3-6 years No

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References

  1. NHMRC, Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, National Health and Medical Research Council, Australian Government, Canberra, 2003.
  2. Douketis JD, et al, Systematic review of long-tern weight loss studies in obese adults: clinical significance and applicability to clinical practice. International Journal of Obesity 2005; 29:1153-67.