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There is increasing recognition that obesity is a serious medical condition. Strategies for both prevention and treatment should include a combination of dietary intervention, behavioural therapy and promotion of physical activity. Effective management by a multi-disciplinary team is important, with equal focus on both weight reduction and weight maintenance.
]]> ]]> Obesity Treatment – Importance of Realistic Weight Loss Goals
There are a wide variety of dietary interventions available for the treatment of obesity, including low calorie diets, very low calorie diets, milk diets and novel diets. Unfortunately, with many diets, long term follow-up shows that much of the weight lost is re-gained. For dietetic success, it is important to focus on the patient’s individual needs, to set realistic goals, to instigate small achievable changes rather than large changes, and to focus on weight maintenance. Dietary strategies form an important part of the treatment of obesity.
Obesity & Body Image Link
A deeper understanding of weight control and problem solving amongst health professionals should be encouraged. In terms of behavioural therapy, flexible long-term strategies that deal with both diet and activity should be promoted. Emotional issues also need to be addressed. ‘Body image dissatisfaction’, for example, is highly correlated with obesity, particularly amongst women and younger people; ethnicity can also influence body image. Cognitive behavioural treatments are increasingly addressing the reduction of ‘body image distress’; this can make a significant contribution to wellbeing.
Obesity Tretment & Physical Activity
Another important consideration in terms of treatment is that of physical activity. There are many benefits of exercise, which go far beyond weight control. For example exercise can reduce depression, anxiety and stress; it can enhance mood and self-esteem; and it can improve sleep quality. There is an increasing trend in inactivity in the UK at the present time, especially in children, and this is a problem that needs to be tackled if the trend in obesity is to be reversed. Recommendations for obese people, in terms of activity, are that: the amount of time spent in sedentary activities should be reduced; vigorous activity should be avoided, bouts of longer periods of moderate and sustained exercise would be more beneficial; and more weight bearing movement should be encouraged.
Obesity Treatment – Anti-Obesity Drugs
In those who are clinically obese, where methods such as dietary intervention, behavioural therapy and promotion of physical activity have failed to achieve a weight loss of 10% after 3 months of managed care, it may be appropriate to consider an anti-obesity drug. Orlistat, for example, which is a pancreatic lipase inhibitor, has been available in the UK since 1998. Sibutramine, which promotes satiety, is currently licensed for use in Germany, and may become available in the UK later this year. The recent withdrawal of fenfluramine and dexfenfluramine, as a result of safety concerns, underlies the importance of continued monitoring of anti-obesity drugs to ensure there are no adverse effects.
Click Obesity Information for page 1 on Obesity Conference Findings.
Source: British Nutrition Foundation Conference on Obesity (May,1999)
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