Treatment measures for obesity

Obesity has become an epidemic worldwide, and the class of losing weight and preventing obesity needs to be read frequently. We must vigorously promote the knowledge of weight loss, anti-obesity and health protection, so as to arouse the whole society s awareness and concern about the harm of obesity and its complications.

Reduction of excess weight Weight loss of 5 to 6 kg or 10% of initial weight is successful. Because returning to normal weight is often unrealistic, it may not necessarily be the ultimate goal of a weight loss strategy, and proper weight loss does have health benefits.

The specific value of maintaining body mass index (BMI) should be determined according to different regions and populations. For example, the Asian population should be <23 kg / m3.

Changes in the main way of living Weight control strategies include changing diets, increasing physical activity, and improving lifestyle habits and perceptions. Some special habits promote excessive eating or reduced activity, and they should be properly recognized and corrected. It is easier to achieve and maintain weight loss through behavior correction.

All weight control strategies require the patient to be educated about food and healthy eating habits. Patients should avoid hobby diets. The key to dietary therapy is to instruct patients to change their diets to limit heat intake. According to healthy dietary principles, such as individualized energy-deficient meals (fixed-energy meals) and free-fed meals with low-fat, high-carbon hydrates, better results can be achieved, and patients avoid fashionable meals.

Physical activity is another important factor for weight control. If you increase physical activity or exercise alone to treat obesity, it may reduce 4 to 5 kg in 3 months. Emphasis should be placed on increasing habitual daily activities such as walking and climbing stairs. Obese patients do not need to perform high-intensity activities, mild to moderate is sufficient.

Drug treatment In some cases, drug treatment needs to be considered in addition to diet, exercise, and behavior correction. Drug therapy can only be used as an aid to diet control and exercise for obesity. Drug treatment should be considered when:

Phenfenfluramine and dexfenfluramine are relatively effective weight-loss drugs, but they have automatically withdrawn from the drug market due to drug-related complications of primary pulmonary hypertension and heart valve hypertrophy.

Fluoxetine is an antidepressant that acts on serotonin. It has a mild effect on the appetite and weight of the user. It can replace anorexia, especially for obese patients with depression.

Phentermine and bupropion are amphetamine derivatives, which can effectively suppress appetite and weight loss. Due to its stimulating effect on the central nervous system, only short-term (less than 3 months) medication is recommended.

West Sibutramine, which acts by acting on serotonin and norepinephrine bypass, improves satiety and reduces energy intake by inhibiting serotonin and norepinephrine reuptake.

Metformin can effectively control the weight of patients with type 2 diabetes and polycystic ovary syndrome. This product is very effective for patients with impaired glucose tolerance, and sometimes it can also be used alone to treat obesity. Those who have heart failure, liver and kidney disease should pay attention to observation, because the drug may cause lactic acidosis.

Very low-calorie meals, although weight loss can be achieved through dieting, but very low-calorie meals generally refer to commercial packaged foods that use high-quality protein, vitamins and major minerals plus enough carbohydrates to prevent electrolyte loss.

Ultra-low-calorie diets usually range from 400 to 800 calories / day, which may reduce weight in the short term. However, it does not change dietary habits, nor can it be used for a long time to reduce weight. Although the use of very low-calorie diets can lead to rapid weight loss in the short term, weight gain is usually greater thereafter, and the importance of behavioral and lifestyle changes should be emphasized.

Individuals before using a very low-calorie diet, individuals should first conduct a healthy diet and increased activity test. An extremely low-calorie diet is an effective weight loss treatment for patients who are extremely obese or who need to lose weight quickly for medical reasons . But under the guidance of a doctor.

Surgery. For obese people with a BMI ≥40kg / m2, gastric separation is an effective treatment. Postoperative volume of the proximal stomach is ≤80m1, and satiety after eating is caused by vagus nerve reflex. Other surgical methods include gastric bands or staples, laparoscopic placement of adjustable inflatable bands, and gastric-jejunal bypass.

Treatment of childhood obesity. The difference between obesity treatment for children and adults is that preventing weight gain is more important than trying to lose weight. As children grow, body tissue tends to increase, so reducing or maintaining a constant adipose tissue will help normalize weight .

The best and most effective way to treat childhood obesity is by encouraging exercise and healthy eating habits for the entire family, not just for the children themselves.

By increasing the overall activities and games in the school, it is more effective to achieve higher energy consumption than competitive or collectively organized sports. In developed countries, the current increase in the prevalence of childhood obesity appears to be related to the time spent pursuing non-exercise, leisure, sedentary behavior. Watching TV, using computers, and playing video games are prevalent, which is the main reason why children are not active.

The drug treatment effect of obesity in children and adolescents has not been determined, but it can be considered in some extreme cases. There is almost no data on the efficacy and efficacy of drug treatment in adolescents (under 18 years). As for the diet of obese children, the heat intake can only be reduced by a small amount to ensure that sufficient energy and nutrition are obtained to maintain normal growth and development. Very low-calorie diets are generally not recommended during childhood.

BMI is 23-25kg / m2 without other risk factors such as diabetes or only increased waist circumference (men> 90cm, women> 80cm) can choose diet control and increase physical activity; accompanied by diabetes, coronary heart disease, hypertension and high fat In addition to dietary control and increased physical activity, people with anemia should also be treated with medication.

BMI at 25 ~ 30kg / m2 without diabetes and other risk factors or with an increase in waist circumference only. In addition to dietary control and increased physical activity, drug treatment can be considered; those with diabetes, coronary heart disease, hypertension and hyperlipidemia should be controlled Diet, increase physical activity, and use medication.

BMI \\ u0026 gt; 30kg / m2 without diabetes and other risk factors can consider drug treatment in addition to dietary control and increased physical activity; those with increased waist circumference need to be treated with medication in addition to dietary control and increased physical activity; accompanied by diabetes, coronary heart disease, Hypertension and hyperlipidemia, intensive diet control, physical activity and drug treatment should be used.

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