Clinical Guidelines of Treatment of Obesity in Adults

ABSTRACT

Obesity increases the risk of serious medical conditions such as type 2 diabetes and coronary heart disease. The risks associated with comorbidities can be reduced with a modest weight loss. Obesity should be recognized and treated as a chronic, progressive, and relapsing disease. The management of obesity requires a long-term approach that is tailored to an individual's lifestyle and needs. Initial treatment should focus on lifestyle changes, i.e., reduced calorie intake and increased physical activity, with behavior modification strategies. Medications may be used adjunctively. Most of FDA-approved anti-obesity drugs should be prescribed for short-term weight loss. Recently, sibutramine and orlistat were approved for long-term weight loss and maintenance. In addition to weight reduction, sibutramine and orlistat provided beneficial effects on cardiovascular risk factors in clinical trials. Several drugs, such as fluoxetine, bupropion and topiramate, approved for other uses, have shown weight loss in some clinical trials. Surgical treatment should be reserved for severely obese patients with significant medical comorbidities or physical conditions.