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Conventional Treatment of Obesity

Allopathic medicine treats obesity with dietary guidelines, exercise, drug therapy, and/or surgery.

Weight gain can from a variety of reasons.

Occasionally, an underlying medical condition may be causing weight gain. A doctor's examination and blood testing will rule out endocrine or metabolic problems, such as hypothyroidism, adrenal disease (Cushing's syndrome), pituitary disorders, or genetic diseases.

Food allergies and intolerances may also contribute to weight gain for may people.

If there are no signs of underlying problems, then the allopathic treatment generally is to recommend dietary changes and regular exercise. A special diet is usually recommended.

Exercise is crucial to any weight-loss program. One study found that 95 percent of patients on a weight-loss diet regained the pounds they had lost if they did not include exercise as part of their overall program. Other factors, such as the fat and fiber content of your diet, also play a major role, but nothing is as important as exercise.

A low-fat, low-sugar, high- fiber diet will help you achieve your goal of weight reduction. Augment this with a simple exercise program to your weekly routine. This can be something as simple as a 30-minute walk at lunch. There is some evidence that a long-term, strict regimen of regular exercise and a moderate, low-fat diet can permanently lower your set point, making it easier for you to sustain a lower weight.

Behavior modification is another commonly prescribed tool for weight problems.

Your doctor, in some instances, may recommend a drug that suppresses appetite. In 1999, the drug orlistat was approved by the Food and Drug Administration (FDA) as an obesity treatment. Orlistat works by reducing the body's ability to absorb dietary fat by about one third.

Most currently available weight-loss medications are approved by the FDA for short-term use, meaning a few weeks or months. Sibutramine and orlistat are the only weight-loss medications approved for longer-term use in significantly obese patients, although the safety and effectiveness have not been established for use beyond 1 year. (See table below for the generic and trade names of prescription weight-loss medications.) 

Another medication used is fluoxetine, an antidepressant that has also been found to suppress appetite. Medications should be avoided and should be one of the last resorts. They do nothing to address the behavior patterns that led to obesity in the first place, and they can produce serious side effects.

Medications that affect catecholamine levels (such as phentermine, diethylpropion, and mazindol) may cause symptoms of sleeplessness, nervousness, and euphoria (feeling of well-being).

Sibutramine acts on both the serotonin and catecholamine systems. Sibutramine does not cause release of serotonin from cells. The primary known side effects of concern with sibutramine are elevations in blood pressure and pulse, which are usually small but may be significant in some patients. People with poorly controlled high blood pressure, heart disease, irregular heart beat, or history of stroke should not take sibutramine, and all patients taking the medication should have their blood pressure monitored on a regular basis.

Some side effects with orlistat include oily spotting, gas with discharge, urgent need to go to the bathroom, oily or fatty stools, an oily discharge, increased number of bowel movements, and inability to control bowel movements. These side effects are generally mild and temporary, but may be worsened by eating foods that are high in fat. Also, because orlistat reduces the absorption of some vitamins, patients should take a multivitamin at least 2 hours before or after taking orlistat.

Primary pulmonary hypertension (PPH) is a rare but potentially fatal disorder that affects the blood vessels in the lungs and results in death within 4 years in 45 percent of its victims. It should be noted that the vast majority of cases of PPH have occurred in patients who were taking fenfluramine or dexfenfluramine, either alone or in combination. There have been only a few case reports of PPH in patients taking phentermine alone, although the possibility that phentermine alone may be associated with PPH cannot be ruled out. No cases of PPH have been reported with sibutramine, but because of the low incidence of this disease in the underlying population, it is not known whether or not sibutramine may cause this disease.

Notify your physician if you have any of the following medical conditions:

• Pregnancy or breast-feeding

• History of drug or alcohol abuse

• History of an eating disorder

• History of depression or manic depressive disorder

• Use of monoamine oxidase (MAO) inhibitors or antidepressant medications

• Migraine headaches requiring medication

• Glaucoma

• Diabetes

• Heart disease or heart condition, such as an irregular heart beat

• High blood pressure

• Planning to have surgery that requires general anesthesia

FDA Approved Fat Loss

If you or anybody you know is reaching for supposed FDA approved fat loss drugs such as Wellbutrin, it would be wise to pay full attention to the next few paragraphs.

Surgery

Surgery is sometimes used as a last resort for severe obesity that responds to no other measures. It removes the need for appetite suppressants. The procedures used include gastric banding, in which a portion of the stomach is stapled closed, and gastric bypass, which also decreases the stomach's capacity. Weight loss immediately following surgery can be impressive. However, long-term success is only in the 50-percent range.

Two other techniques used, liposuction and jaw wiring, have several drawbacks and should rarely if ever be considered.

The jaw can also be wired together, leaving only enough space so a liquid diet can be consumed. Jaw wiring can damage gums and teeth and cause muscle spasms in the jaw joint. The liquid diet that such patients must eat does result in weight loss, but as soon as the wires are removed patients almost always put back on what they lost.

Liposuction is a surgical procedure that involves sucking out fat cells. To perform liposuction, the surgeon makes a small incision near fatty deposits and then suctions the fat out. Very little fat can be removed, however, because of potential risks to blood vessels and nerves. The long-term implications of this procedure are not yet known. It is performed for cosmetic reasons on people slightly overweight to make them look good rather than for any medical reasons.