Medical treatment of obesity : Medicaments, Bariatic surgey, guidelines

More and more experts say the main goal of treatment expected to be adoption of better habits. Thus, the present and future health is improved. Weight loss which may result should rather be seen as a "side effect".

A global approach

The most effective approach to improve its long-term health is personalized, multidisciplinary and requires regular monitoring. The therapeutic approach should ideally include the services of the following professionals: a doctor obesity, a dietitian, a kinesiologist and psychologist.

We must start with a checkup by a doctor obesity. Would follow consultations with other health professionals. It is better to bet on a phased monitoring over several years, even during the weight maintenance phase. Unfortunately, few clinics offer such support.

According to experts at the Mayo Clinic in  US, a weight loss is corresponding to 5%-10% of body weight can improve health significantly. For example, for a person weighing 90 kilograms, or 200 pounds (and being obese by body mass index), this corresponds to a loss of weight of 4 to 10 kilos (10-20 pounds).

Psychotherapy

Consult a psychologist or psychotherapist can help to understand the origin of overweight, change eating behaviors to better deal with stress and regain their self-esteem, etc. Visit our Psychotherapy sheet.

Medicaments helps to lose weight

Some prescription medications can help lose weight. They are for people who have significant risk factors for cardiovascular disease, diabetes, hypertension, etc. 

These medications cause a modest weight loss (2.6 kg to 4.8 kg). We must continue to take them for the effect remains. In addition, they must be associated with a strict diet and have several cons-indications.

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

Common side effects: 

• liquids and oily stools, 
• an urgent need to defecate, 
• flatulence, 
• abdominal pain.

Note. In the US and Europe, orlistat is available over the counter at a reduced dosage in half, under the commercial name Alli® (in France, the drug is kept behind the pharmacy counter). Alli® the medicament is for overweight people. It can cause the same types of undesirable effects that Xenical.

It must also be accompanied by a low-fat diet. 

The cons-indications apply. It is recommended to consult a doctor obesity before starting treatment with this medication in order to get a health check and a comprehensive approach to weight control.

Bariatic surgery

Bariatric surgery is usually to reduce the size of the stomach, which reduces the intake of food by about 40%. It is reserved for people who are morbidly obese, that is to say, those whose body mass index is over 40, and those with a BMI above 35 and who are suffering from a disease related to obesity.

Note. Liposuction is a cosmetic surgery and should not be used to lose weight, according to experts at the Mayo Clinic in the United States.