The best treatment for obesity is with a diet to lose weight and regular exercise, however, when this is not possible, there are medication options to help reduce appetite and binge eating, such as Sibutramine and Orlistat, or, in the last case, bariatric surgery, which reduces the area of absorption of food by the gastrointestinal tract.
The first step, both to treat and prevent obesity, should always be the control of calorie consumption, calculated according to the usual diet and the amount of weight you want to lose, preferably with a diet rich in fruits, vegetables, fiber and water, as directed by the nutritionist. To find out what an ideal weight loss diet should be, check out our fast and healthy weight loss diet.
However, in addition to diet and physical activity, other treatments for obesity that can be guided by an endocrinologist or nutrologist, include:
1. Medicines for obesity
The use of drugs to treat obesity are indicated in the following cases:
- BMI greater than 30kg / m2; BMI greater than 27kg / m2, with other related diseases, such as diabetes, high cholesterol and high blood pressure; People with any type of obesity who are unable to lose weight with diet and exercise.
Drug treatment should be aimed at people who are involved in a lifestyle change program, with dietary guidance and practice of activities, otherwise it will not have a satisfactory effect.
The options for weight loss drugs are:
| Types | Examples | How they work | Side effects |
| Appetite suppressants |
Sibutramine; Amfepramone; Femproporex. |
They increase satiety and decrease hunger, which reduces calorie consumption throughout the day, by increasing neurotransmitters such as norepinephrine, serotonin and dopamine. | Increased heart rate, increased blood pressure, dry mouth, headache and insomnia. |
| Absorption reducers in the gastrointestinal tract | Orlistat | They inhibit some enzymes in the stomach and intestine, which blocks the digestion and absorption of part of the fat in food. | Diarrhea, smelly gases. |
| CB-1 receptor antagonist | Rimonabant | They block brain receptors to inhibit appetite, increase satiety and decrease food impulsivity. | Nausea, mood swings, irritability, anxiety and dizziness. |
| Thermogenic | Ephedrine | Increase energy expenditure throughout the day. | Excessive sweating, increased heart rate, increased blood pressure. |
There are also drugs used to treat other diseases that can help fight obesity, such as antidepressants, and some examples are Fluoxetine, Sertraline and Bupropion.
These drugs can only be used with strict medical guidance, preferably with experience in the use of these drugs, as endocrinologists and nutrologists, due to the amount of side effects, which require periodic attention and monitoring.
2. Bariatric Surgery
Bariatric surgery is indicated in the following cases:
- Morbid obesity, with a BMI greater than 40kg / m2; Moderate obesity, with a BMI greater than 35mg / m2, associated with uncontrolled obesity diseases, such as diabetes, sleep apnea, high blood pressure, high cholesterol, cardiovascular diseases, stroke, arrhythmias and osteoarthritis.
Some types of surgery most performed are:
| Type | How it is done |
| Gastric band | An adjustable band is placed to decrease the diameter of the stomach. |
| Gastric bypass | It causes the stomach to shrink with deviation of the remainder to the intestine. |
| Biliopancreatic shunt | It also removes part of the stomach, creating another type of diversion to the intestine. |
| Vertical gastrectomy | Much of the stomach responsible for absorption is removed. |
Another option for a less invasive procedure is the placement of a temporary intragastric balloon, indicated as an incentive for some people to reduce food consumption for a period.
The type of surgery indicated for each person is decided by the patient in conjunction with the gastric surgeon, who assesses the needs of each person and the procedure that can best suit. Better understand how it is done and how is recovery from bariatric surgery.
Tips for not giving up treatment
The treatment for obesity is not easy to follow because it involves changing the eating habits and lifestyles that the patient has done for a lifetime, so some tips to help not give up the treatment can be:
- Establish weekly goals that are possible to achieve; Ask the nutritionist to adjust the diet if it is too difficult to accomplish; Choose a physical exercise that you like, and practice on a regular basis. Find out which are the best exercises to lose weight; Record the results, writing down measurements on a paper or with weekly photographs.
In the following video, see important tips from the nutritionist to lose weight more easily:
Another important guideline to keep the weight loss focus is to keep a monthly or quarterly follow-up with the nutritionist and the doctor, so that any difficulties or changes during the treatment are more easily resolved.
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 obtain information about referrals and consultations at the health center.
