Treatment for Obesity

Reviewed by: HU Medical Review Board | Last reviewed: June 2023

About 70 percent of adults in the U.S. are overweight or have obesity. If you are dealing with with excess weight or obesity, you may be considering losing weight.1

Obesity is a medical condition in which excess weight may cause health issues like diabetes, high blood pressure, and heart disease. For those who need it, weight loss can improve overall health and well-being.1,2

There are many treatment options available to help you reach your goals. Weight loss can be achieved through a combination of:2,3

Even with these options, weight loss can be a challenging journey. But with the correct information, guidance, and support, it is possible. Before you embark on a new weight loss journey, speak with your doctor. They can develop a weight loss plan that is right for you and your goals. Or they can connect you with other weight loss and nutrition specialists.3

Do you need to lose weight?

The first question on your weight loss journey should be: Do you need to consider losing weight in the first place? This is a question for you and your healthcare provider to answer together. It will depend on many factors, including your:1-4

  • Health history
  • Family history
  • Any current medical issues you may have
  • Body mass index (BMI)

BMI is a proportion between your height and your weight. It is a way to put people in the categories of overweight and obese. A person with a BMI score between 25 and 30 is considered overweight. A person with a BMI score of 30 or above is considered obese. You can calculate your BMI here.2,4

However, BMI is just one way to measure overweight and obesity. It may not account for muscle mass or other differences in body composition.2,4

Who treats obesity?

When it comes to treating obesity, you may have many experts on your care team. Members of your team may include:5,6

  • Primary care provider – Your primary care provider can assess your overall health, give advice on weight management, and help determine the best treatment options.
  • Registered dietitian (RD) – A dietitian can help you develop a personal meal plan, educate you about good nutrition, and help you make healthy food choices.
  • Psychologist/counselor – For many, weight loss is an emotional experience. A psychologist or counselor can provide support and address any underlying issues related to food, self-esteem, or body image.

Behavior and lifestyle changes

For most people on a weight loss journey, lifestyle changes are the first line of treatment. Here are some effective strategies:2-4

  • Healthy eating – Focus on a balanced diet that includes whole grains, lean proteins, fruits, vegetables, and healthy fats. Portion control is vital. So is reducing the amount of processed foods, sugary drinks, and snacks.
  • Calorie restriction – When you burn more calories than you consume through eating or drinking, you lose weight. But how you restrict your calories will depend on your weight and activity level. Talk to your doctor and/or a dietitian about how many calories you should consume to eat each day.
  • Regular physical activity – Regular exercise is great for overall health. Aim for a mix of aerobic activities (brisk walking, cycling, swimming) and strength training (lifting weights, bodyweight exercises) to build muscle and increase metabolism.
  • Behavior changes – Identify and address unhealthy eating habits and emotional eating triggers. These behaviors contribute to weight gain. Seek support from specialists who can guide you through these changes.

Special diets

For some, special diets can play a significant role in weight loss treatment. These diets focus on whole foods, lean proteins, and plenty of fruit and vegetables. Examples include the low-carb, Mediterranean, and ketogenic diets.2,7

By restricting certain foods or controlling portion sizes, special diets can help reduce your calorie intake and promote weight loss. Some diets may even hold extra benefits like improving insulin sensitivity or reducing inflammation.2,7

Always talk with your doctor or a dietitian before starting any special diet to make sure it is safe and appropriate for you.2,7

Weight management programs

There are many weight management programs to choose from. Choose one that is right for your goals and lifestyle.5,6

Medically supervised meal replacement plans, such as Medifast and Optifast®, can be a convenient and calorie-controlled option for weight loss. These should be used only under the guidance of a healthcare professional.6,7

Other weight management programs are available to the public via subscription. These diet programs include Atkins™, Weight Watchers®, and Noom®. They are available on the web and through mobile apps. They provide resources, recipes, and advice on how to lose weight and keep it off.1

Experts recommend that whatever weight management program you choose, it should prioritize:1

  • Slow and steady weight loss
  • Healthy and sustainable goals
  • Regular check-ins and feedback
  • Some form of behavioral treatment, like counseling
  • A plan to keep the weight off

Weight loss medicines

Your doctor also may prescribe medicines to help you lose weight. These medicines work by making you feel less hungry and more full. Some work by reducing fat absorption or increasing metabolism. Metabolism is how your body turns food into energy.8

Several weight loss drugs have been approved by the US Food and Drug Administration (FDA), including:8

  • Bupropion-naltrexone (Contrave®)
  • Setmelanotide (Imcivree™)
  • Tirzepatide (Mounjaro™) – approved to treat type 2 diabetes
  • Orlistat (Xenical®, Alli®)
  • Semaglutide (Ozempic®, Wegovy®) – approved to treat type 2 diabetes
  • Phentermine-topiramate (Qsymia®)
  • Phentermine (Adipex-P®, Lomaira™)
  • Liraglutide (Saxenda®)

Weight loss drugs are not right for everyone, and they all have potential side effects. Talk with your doctor about the possible risks, benefits, and side effects of weight loss drugs.8

Surgery for weight loss

In severe cases of obesity or when other methods have failed, surgery may be recommended. These procedures make changes to your digestive tract to help you lose weight. Common surgical options include:9

  • Gastric bypass – This procedure involves creating a smaller stomach pouch and rerouting the digestive tract. This reduces the amount of food you can eat.
  • Gastric sleeve – Also called a sleeve gastrectomy, this surgery removes about 80 percent of the stomach, leaving a smaller pouch. This restricts food intake and reduces hunger by affecting the gut hormone called ghrelin.
  • Biliopancreatic diversion with duodenal switch (BPD-DS) or gastric band – This surgery makes your stomach smaller and changes the way food travels through your digestive system. When your stomach is smaller, you feel full with less food.

Other things to consider

Before starting a weight loss journey, consider all of the following:2-4,6

  • Take a personalized approach. Everyone's weight loss journey is unique. What works for 1 person may not work for another. Find an approach that suits your needs, preferences, and medical conditions.
  • Focus on sustainability. Look for strategies that can be maintained in the long run. Fast weight loss may give short-term results. But this is often challenging to sustain over time and can be dangerous for your body. Slow and steady weight loss is best.
  • Lean on your support system. Rely on family, friends, or support groups who can provide encouragement and motivation throughout your journey.
  • Take care of other health considerations. Obesity-related conditions, such as diabetes or high blood pressure, may need more medical attention. Talk with your doctor to ensure your weight loss efforts align with any existing treatments or medicines.

Weight loss is a personal journey that requires patience, commitment, and the right tools. Embrace healthy eating habits, exercise regularly, and seek support from health experts who can guide you toward sustainable weight loss.

Remember, achieving a healthier weight is not just about physical appearance. It will improve your overall well-being and let you enjoy a better quality of life.

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