The treatment of obesity is a comprehensive medical process aimed at safely and effectively reducing weight, decreasing the risk of related complications, and improving overall quality of life. Treatment strategies are typically tailored based on the patient's Body Mass Index (BMI), health status, and individual needs, emphasizing long-term weight maintenance rather than short-term weight loss.
Modern medical recommendations suggest that treatment should combine medical monitoring, behavioral modification, and, when necessary, pharmacological or surgical interventions. Physicians will assess risks and benefits based on the patient's specific circumstances, set phased goals, and regularly track progress to adjust the plan. This process requires active cooperation between the patient and the healthcare team to achieve sustainable health improvements.
Today, treatment options for obesity include medications, surgery, behavioral therapy, and technological aids. The main treatment directions include:
Pharmacological treatment is usually used for patients with BMI ≥30 or BMI ≥27 with metabolic diseases such as diabetes. Currently approved drugs fall into the following categories:
Medications such as Liraglutide mimic the effects of incretin hormones, delay gastric emptying, and increase satiety. Studies show an average weight reduction of 5-10%, along with improved blood glucose control. Potential side effects include nausea or gastrointestinal discomfort.
Drugs containing coenzyme A derivatives can block appetite-stimulating signals, suppressing overeating. Some medications need to be used in conjunction with a low-calorie diet to achieve optimal results. Physicians will evaluate suitability based on the patient's liver function.
Surgical treatment is a critical option for severe obesity but requires strict adherence to criteria. Main types of surgery include:
This procedure reduces stomach capacity and alters intestinal structure, decreasing food absorption and reducing ghrelin secretion. Long-term follow-up shows a weight loss of 15-30%, but suitability depends on whether the patient has severe metabolic diseases (e.g., BMI ≥40) and the risk of postoperative nutritional deficiencies.
Emerging endoscopic weight loss procedures include gastric balloon placement or intestinal stenting, which are less invasive than traditional surgery but have a narrower scope of application. Physicians will evaluate based on the patient's metabolic index, age, and comorbidities.
Behavioral therapy forms the foundation of all treatment plans, requiring structured programs to change daily habits. Key elements include:
Psychological therapy can help address binge eating or emotional eating issues. Cognitive Behavioral Therapy (CBT) assists patients in identifying triggers and establishing alternative behavioral patterns. Support groups provide peer communication platforms to enhance treatment motivation.
Emerging research focuses on gene therapy, gut microbiota modulation, and neuroregulation techniques. Genetic studies have identified polymorphisms such as FTO associated with obesity, which may lead to targeted drug development in the future. Fecal microbiota transplantation experiments have shown that certain bacterial strains can improve metabolic indicators, but clinical applications are still in the experimental stage.
Wearable devices combined with artificial intelligence are increasingly becoming auxiliary tools, capable of real-time monitoring dietary intake and activity levels, and providing personalized recommendations through algorithms. Additionally, intestinal nerve stimulation devices are under testing, aiming to regulate hunger signaling pathways.
Patients with a BMI over 30 accompanied by hyperlipidemia, sleep apnea, or other metabolic diseases should seek evaluation from a weight management specialist. If non-pharmacological treatment for six months fails to meet targets or complications such as fatty liver develop, re-evaluation of treatment intensity is necessary.
Assessment for surgery requires meeting specific criteria, such as BMI ≥35 with cardiovascular disease or BMI ≥40 without complications. Physicians will conduct comprehensive examinations to exclude other metabolic abnormalities and explain long-term pre- and post-operative care requirements.
Aerobic exercise can quickly burn calories and is recommended as the main focus during the initial phase of weight loss; weight training helps increase muscle mass to boost basal metabolic rate and maintain weight in the long term. It is advisable to combine three sessions of aerobic exercise (such as jogging or swimming) with two sessions of resistance training weekly for more stable weight loss results.
Why do some people find it difficult to lose weight even with diet control?This may be due to hidden calorie sources not being accounted for (such as sauces or processed foods), or a decreased metabolic rate caused by long-term calorie restriction. It is recommended to use diet tracking apps for precise monitoring and to adjust diet structure and caloric deficit under medical guidance to avoid plateauing.
How do medications in obesity treatment work, and what side effects should be watched for?Current medications typically work by suppressing appetite, delaying gastric emptying, or blocking fat absorption. Common side effects include nausea, diarrhea, or gastrointestinal discomfort, and regular monitoring of liver function or blood pressure is necessary. Prior to use, BMI and comorbid risks should be evaluated by a physician, as not all patients are suitable for medication therapy.
How does long-term stress affect weight management?Stress stimulates cortisol secretion, which promotes abdominal fat accumulation and can trigger emotional eating behaviors. It is recommended to practice mindfulness meditation, maintain regular sleep patterns, engage in aerobic exercise to metabolize stress, and adjust eating habits through behavioral therapy to effectively break the vicious cycle of stress and obesity.
When should weight loss surgery be considered?When BMI exceeds 32 with obesity-related diseases such as diabetes or sleep apnea, or BMI exceeds 37 with failure of non-surgical treatments, procedures like gastric bypass or sleeve gastrectomy can be considered. The decision should be made after comprehensive evaluation by a multidisciplinary team, including assessment of surgical risk scores (SRS) and long-term nutritional follow-up.
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