Obesity, known as the cause of many acute or chronic terminal diseases, is one of the most common illnesses of the modern era.
Obesity is a clinical condition arising because of the excess calorie intake turning into fat, getting stored in the body.
Human body is genetically designed to consume food to cope with hunger and store up. Therefore, the fats, of which in 1 gram has the highest calorie, have been selected as storage energy. Fat tissue is accumulated in various parts of the body. The accumulated fats are especially around the parts of the internal organs, belly, hip and breasts of women.
When the accumulated fat starts to affect the daily life and activities negatively, it turns into a disease; hence, it is to be treated.
The methods used in the obesity treatment is combined in 4 groups, which are diet, medication, exercise and behavioural therapy.
Diet Treatment In Obesity
Diet plays a crucial role in obesity treatment. Thus, it is important to have healthy eating habits decreasing the calorie intake. It should be acknowledged that the diet therapy is customized. The weight loss diets should be in harmony with the principles of adequate and balanced nutrition that aims to make the patients have the correct, sustainable nutrition habits.
Reducing the calorie: The key to lose weight is directly related to the amount of the decreased calorie intake. To lose 0.5-1 kg a week, the daily calorie intake should be reduced up to 500-1000 calories. In general, women should take 1000-1200 calories, while men should get 1200-1600 calories to safely lose weight.Lower calorie diets are highly risky unless you are under the supervision of a medical expert.
More satiety eating less:Food with the highest amount of energy is mainly the desserts, bread, fatty and processed food. Even a small amount of the mentioned ones contains high calorie. Vegetable, fruit and legumes are the food with low calories. Even the larger portions of them provide lower calorie intake. Consuming the low energy food ensures the state of saturation with lower calorie.
Making healthy choices: You should consume plant-based food such as fruit, vegetables and legumes as well as the high protein ones to make your diet healthier.
Avoiding certain nutrients: In many diets the amount of fatty and high carbohydrate food is reduced. Sweet drinks or beverages with sweeteners cause you to use up more calories unintentionally.Avoiding these food and beverages in your nutrition plan permanently helps you to reduce the calorie intake. Your diet should not include trans and saturated food along with salt, refined sugar and cholesterol.
Nutritional supplement: In a day you should have 3 main courses and 3 snack times. You should consume healthy snacks such as apricots, almonds, walnuts. You should have realistic targets before getting on a diet. Despite losing 10% of your body weight, if you are still in the obesity ranges, you should consider the other alternative methods.
Exercise Treatment In Obesity
Physical activities have the effect of reducing the fat around the belly and the fat tissue; that’s why, adults are recommended to take an average of 30 minutes exercise daily, which helps use up 840kcal energy daily. The most important issue for the obese individuals is to take the injury risk into consideration while increasing energy use-up.
What important is to get sustainable exercises:You should decide which activities are applicable to your daily routine to make the sports a significant part of your daily life routine. Average exercise is the one helping the body warming and increasing the heart rate (aka cardio exercises).After losing weight, it is important to take 60 minutes light exercises daily which is very effective to prevent regaining the weight.
The significance of exercise to prevent child obesity: Children as well as the adults should take 60 minutes moderate exercises daily. The activities can be riding a bike, climbing up the stairs, gardening, swimming or exercising at the gym. Except increasing the exercises, obese individuals should reduce the sitting time. Using up calorie by increasing the exercise time helps keep the weight and lose the weight as well. Besides, the risk of having a cardiac arrest or a heart related issue risk could be reduced.
Medication Treatment In Obesity
It is rare to treat obesity using medication. The up-to-date medications approved by FDA are Orlistat (Xenical), Lorcaserin (Belviq) along with Osymia, consisting of the mixture of delayed release drug and phentermine.
Orlistat: The losing weight effect of Orlistat, which reduces the digestion and absorption of triglycerides by blocking the lipase enzyme secreted from the pancreas is not based on the absorption of the system of the drug. Orlistat has side effects such as fatty stool, frequent defecation, fecal incontinence and increased intestinal gas.
Lorcaserin: The medication, which has a potential addiction risk, was approved by FDA in 2012 and used for the patients BMI 30 and over in addition to the low-calorie diet and exercise program.
Liraglutide (saxenda): It is similar to the GLP1, which is the physiological regulator in calorie intake and appetite. The medication has been approved to use for chronic weight management in addition to the diet and exercise for the obese individuals who are BMI 30 and over.
Phentermine and Topiramate:The combination of these two substances was approved by FDA in 2012 to be used for the patients who are BMI 30 and over. The use of the medication during pregnancy is contraindicated. 5-7% of weight loss has been observed among patients. The extent of weight loss is parallelly increased with the initial weight loss range.
Medications used for short term treatment: In the States, there are 4 agents which are diethylpropion, phendimetrazine, benzphetamine and phentermine to be used for 8-12 weeks. They should be used for the patients BMI 30 and over along with the calorie restriction.
Medications with different indications: Although they are used for totally different treatments as they have triggered the weight loss, they are not to be used in obesity treatment.
Change Behaviour Treatment
Behavioural therapy is a treatment strategy based on the learnable and sustainable data on certain social circumstances. Along with the uncontrollable weight gain, not being able to have positive outcomes from the attempts of diet is closely related to the patient’s not controlling the eating habit. Behavioural therapy has been used in obesity treatment for a long time. The common point of all these approaches is to achieve the life style changes including the healthy eating habits and exercise as well.
There are 8 important components of behavioural therapy;
Observing oneself: The amont, time and variety of the food consumed daily should be recorded.
Stimulant control: The factors triggering the consumption of high calorie food and beverages should be identified.
Eating behaviour control: The simple methods such as leaving the cutlery on the table, chewing the food well before swallowing, not focusing on anything but food itself should be considered.
Reinforcement and strengthening: Some methods such as rewarding the personal surveillance, the changes in behaviour and leaving the food out to be an award can be tried out.
Cognitive re-structuring: New ideas should be replaced against the ones affecting the patient’s weight loss period negatively.
Healthy eating training: The training should aim to provide the patients with the life-long healthy eating habits.
Increasing the physical activities: It is aimed to measure the physical activity using simple tools such as pedometer and gradually increase the activities.
Behavioural contract: Realistic targets should be aimed, and the contract should be on the behavioural change not on weight loss.