Apr
3
Management of Obesity
Filed Under Obesity
Unlike other medical conditions, obesity does not lend itself to the classic medical model where the doctor diagnoses the condition, prescribes a treatment and remains responsible for the treatment outcome. In obesity, the patient exerts the greatest control over the treatment outcome and the success or otherwise of any therapy.
The key aim of weight management is risk factor reduction rather than a return to an ideal of healthy weight range. The first step on this process is a combination of supervised diet, exercise and behavioural change. In children, measurement and plotting BMI is a vital step as research shows that many parents are no longer able to identify whether their children are overweight or not.
In the UK, current dietary allowances are outlined in the Eatwell Plate (www.eatwell.gov.uk) which aims to suggest a proportioned, balanced and healthy diet with a combination of different foods from five groups for children aged two years and over. It should be noted that the consumption of calorically sweetened drinks should be limited as it has been shown that they contribute to the development of obesity in children.
It is also important that children and young people achieve at least 60 minutes (moderate intensity) physical activity each day. Adults should achieve a total of at least 30 minutes on five or more days of the week. It has been shown that individuals that have a genetic mutation associated with high BMI may be able to offset their increased risk for obesity through physical activity.
Although bahavioural changes combined with diet and increased physical activity can lead to weight loss, adults with depression and eating disorders often need ongoing psychological support. Anti-obesity drugs can be considered when there has been no improvement after three to six months in the BMI or reduced markers of co-morbidity.
Anti-obesity drugs
Sibutramine
Sibutramine inhibits the reuptake of noradrenaline and serotonin in the brain and this has the effect of reducing food intake as well as attenuating the fall in metabolic rate linked with weight loss. It is not recommended for patients who are under 18 or over 65 years old. It is available as capsules (prescription needed in the UK) in 10mg and 15mg strengths marketed as Reductil.
Orlistat
The prescription strength product containing 120mg orlistat is marketed as Xenical. It is used in conjunction with a hypocaloric diet in people with a BMI of 30kg/m² or more, or with people with a BMI of 28kg/m² with other risk factors such as type II diabetes and hypertension.
The first and only non-prescription weight loss aid licensed throughout Europe launches this month. The product is called Alli and is available in the UK in capsule form containing 60mg orlistat. It is licensed for use in weight loss for adults with a BMI>28 and will be available through community pharmacies shortly.
Rimonabant
The European Medicines Agency suspended the use of rimonabant (Acomplia) in October 2008 after a review showed that any benefit was outweighed by the risk of psychiatric side-effects (particularly depression) in clinical use.
Resveratrol
It has long been known that the skins of certain fruits (grapes, blueberries and cranberries) and wine contain a compound called resveratrol, which has beneficial antioxidant properties, but that’s not all…
Recent animal and in vitro studies suggest that resveratrol can also have a positive effect on helping to maintain normal-range cholesterol levels, supporting insulin health and optimizing metabolic and immune pathways that protect cells and improve mitochondrial function. A risk free trial of Resveratrol Select Weight Loss formula is available *HERE*
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