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Lifestyle changes — eating healthier and getting more exercise — are considered first-line therapy for obesity. Sometimes a focus on healthy eating and movement can resolve health issues and improve overall wellness, regardless of whether your weight changes. The causes of obesity are complex, and it might also help to be evaluated for any underlying health conditions or see a counselor for any mental health issues.
If you and your healthcare team decide weight loss is an important goal for you, there are several treatments available. You can work with a registered dietitian or physical therapist on meal planning and exercise routines that support a healthy weight. Some people find commercial weight loss programs helpful. Several classes of medications can help promote weight loss. Bariatric (weight loss) surgery is effective at helping some people lose weight, while others try weight loss balloons or other procedures.
Which treatment is right for you will depend on your particular goals and your health history. Your healthcare team can review the options with you and help you make the best choice.
Eating a lower-calorie, nutritious diet may help you lose weight or maintain a balanced weight, feel better, control blood glucose (sugar), and keep cholesterol at healthy levels. Even small changes in what, when, and how much you eat can affect your overall health. Replacing sugary soft drinks with fruit-flavored water or high-calorie snack foods with fresh fruit or vegetables can help you feel better.
There are many diets designed to help people lose weight. No one diet is effective or healthy for everyone. If you’re trying to lose weight, the first change starts with your daily or weekly shopping list. Your healthcare provider can refer you to a registered dietitian who can help you plan meals and choose foods that are best for your health and your specific needs.
A nutritious diet for someone trying to lose weight is not very different from a healthy diet in general. Focus your diet on:
For people trying to lose weight or improve their health, making time for regular physical activity is one of the most important things you can do. In addition to burning calories, exercise can:
Regardless of how it affect your weight, exercise is still highly beneficial for your health.
Regular exercise does not necessarily mean going to the gym or playing sports. Nearly any physical activity that gets you up and moving can provide significant benefits.
If you’re not currently exercising regularly, always make sure to check with your doctor before starting out an exercise program. Many exercises can cause a little discomfort, but pain should never be ignored, during or after exercise. When starting out, make sure to stick with low-impact exercise to protect your joints.
Commercial weight loss programs are a popular way to try to lose weight. Well-known brands include WeightWatchers, Jenny Craig, and Nutrisystem, but there are many other programs available. Some programs involve eating branded, prepackaged meals that must be purchased from the company, while others allow you to eat any food you like but ask you to track points or calories.
Many commercial programs include an aspect of community support, counseling, or behavior change as part of their system. Depending on what works best for you, you can find a program that provides regularly scheduled group meetings, individual counseling, or online community forums.
Depending on your health conditions, some weight loss programs might provide too much or too little of the nutrients you need. Always check with your doctor before making significant changes to your diet.
Several prescribed medications are approved by the U.S. Food and Drug Administration (FDA) to help people lose weight along with diet and exercise. Most medications are indicated for people with a body mass index (BMI) of 30 or higher or for people with a BMI of 27 or higher who also have weight-related health conditions, such as type 2 diabetes, high blood pressure, or sleep apnea.
Phentermine is a stimulant and an appetite suppressant. It is believed that phentermine works by reducing the perception of hunger. Phentermine is usually prescribed for short-term use, and it’s important not to take it longer than your doctor recommends.
Methamphetamine (sold as Desoxyn) and other stimulants are very rarely prescribed to promote weight loss. These drugs can be addictive, so it’s very important to take them only for a limited time and under a doctor’s supervision. They can have multiple side effects, including heart palpitations, high blood pressure, constipation, headache, dizziness, upset stomach, and dry mouth. Let your doctor know if you experience any side effects while taking these medications.
Alli — a formulation of a drug called orlistat — is sold over the counter. Orlistat is a lipase inhibitor that works by preventing your body from absorbing calories from fat in foods. Orlistat is also sold at prescription strength under the brand name Xenical. The drug can cause fecal incontinence, along with other digestive side effects such as bloating, gas, or diarrhea. Taking orlistat for a long time can lead to fat-soluble vitamin deficiencies, so it’s important to let your doctor know if you’re taking it.
Liraglutide is prescribed to treat both diabetes and obesity. It’s sold under the brand name Saxenda when it’s prescribed for obesity. This glucagon-like peptide 1 (GLP-1) receptor agonist signals the pancreas to make more insulin and prevents the liver from releasing glucose. Another medication in this class, semaglutide (Wegovy), is also FDA-approved for obesity. It works similarly by reducing appetite and increasing feelings of fullness.
Tirzepatide (Zepbound), a dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist, is another FDA-approved treatment for obesity. It combines the effects of both incretin hormones to promote weight loss by regulating appetite and blood sugar.
Other GLP-1 receptor agonists are sometimes prescribed off-label for weight management. While GLP-1 receptor agonists are the primary incretin mimetics used to treat obesity, other similar medications, including GIP receptor agonists and dual GIP/GLP-1 receptor agonists, are gaining approval and expanding treatment options.
Most of the side effects of GLP-1s are temporary and involve digestion. These include nausea, acid reflux, constipation, and diarrhea — or rarely, vomiting. There are some concerns about losing muscle mass from these medications, so people using GLP-1 receptor agonists are encouraged to eat the required protein amount and exercise if possible.
Contrave is a combination of two drugs, naltrexone and bupropion. Naltrexone is an opiate antagonist that decreases food cravings, and bupropion is an antidepressant that causes weight loss as a side effect. Common side effects of this drug combination include headache, dizziness, and digestive upset.
Qsymia (phentermine/topiramate) is another combination drug composed of a stimulant/appetite suppressant and an anti-seizure drug that causes weight loss as a side effect.
If diet, exercise, and medications have not resulted in weight loss, and your BMI score is very high or you have serious obesity-related health conditions, your doctor may suggest trying a more invasive treatment. Bariatric surgery, a balloon system, or a vagal nerve blockade have helped some people lose weight when other treatments were ineffective.
Some people undergo bariatric surgery such as gastric bypass (Roux-en-Y), adjustable gastric band (also known as the lap-band or LABG), or sleeve gastrectomy to lose weight. To be eligible for bariatric surgery, it is usually necessary to have a BMI score over 35 — or a lower BMI score as well as medical complications such as poorly controlled diabetes. Bariatric surgery has proven effective for weight loss and can reverse diabetes in many people, enabling them to control blood glucose without insulin or diabetes medication.
Any surgery carries risks. These include:
Weight loss surgery can cause reflux, incisional hernias, leaks, and bowel obstructions.
A gastric bypass surgery is reversible in some cases, while gastric sleeve surgery is not. Gastric sleeve surgeries have a higher risk of causing acid reflux than gastric bypass surgeries. Smoking is not recommended after either one of these surgeries. If you need help quitting smoking, talk to your doctor.
After bariatric surgery, you must drastically change when and how much you eat and increase your exercise levels to avoid side effects. Some people experience poor food absorption in the intestines after bariatric surgery that results in nutritional deficiencies and symptoms such as gas, constipation, and diarrhea.
Obalon, Orbera, and ReShape are temporary balloon systems approved by the FDA to aid weight loss for people with high BMI scores or obesity-related complications. Also called intragastric balloons, these systems work by taking up space in the stomach, making you feel full and causing you to eat less.
Each balloon system is a little different, but most are placed in the stomach by swallowing a capsule, which is then inflated. Most balloon systems are retrieved after a few months via endoscopy, which involves inserting a flexible tube with a camera and tools on it down the throat.
Rare but serious side effects of balloon systems can happen if the balloon deflates, enters the intestines, and causes a blockage that requires surgery to correct.
The vagus nerve carries messages of hunger from your digestive system to your brain. A vagus nerve blockade involves surgically implanting a small electrode onto the vagus nerve in the abdomen. The electrode is controlled externally and can be programmed by a doctor. A vagus nerve blockade is designed to be used for eight years. In addition to the risks of any surgery, vagus nerve blockade can cause pain, heartburn, and nausea, among other symptoms.
If you lose a lot of weight quickly, you may develop significant amounts of loose skin. Some people choose to have plastic surgery to remove it. You can discuss this procedure and any other follow-up care with your doctor.
On MyObesityTeam, the social network and online support group for people with obesity and their loved ones, more than 56,000 members come together to share experiences, seek advice, and offer support.
Have you tried medical treatments for obesity? How was your experience? Join the conversation today to share your experiences and connect with others on MyObesityTeam.
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