Treatments for Obesity

Gastrointestinal surgery provides the most substantial and sustainable weight loss in obese individuals. The procedures are collectively called bariatric (from the Greek words baros [weight] and iatrikos [medicine]) or metabolic (when cardiometabolic risk reduction surgery is the intention) and are among the most common gastrointestinal procedures.

Although bariatric and metabolic surgery procedures are used for the treatment of obesity and diabetes, it is important to make a distinction between bariatric surgery and metabolic surgery. Bariatric surgery is defined as a procedure that is performed for weight control, while metabolic surgery is defined as gastrointestinal surgery performed with the goal of treating diabetes and metabolic syndrome. (45)

Metabolic syndrome is a group of disorders that occur at the same time and increase the risk of heart disease, stroke, and type 2 diabetes. These disorders include increased blood pressure, high blood sugar levels, excess body fat around waist and abnormal levels of cholesterol or triglycerides.

Having just one of these disorders does not mean that you have metabolic syndrome. But it does mean that you have a higher risk of getting a serious illness. And if you develop more of these disorders, your risk of complications, such as type 2 diabetes and heart disease, increases even more.

Bariatric surgical procedures cause weight loss by restricting the amount of food the stomach can hold, causing nutrient malabsorption, or by a combination of gastric restriction and malabsorption.

Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic surgery).

The International Federation for the Surgery of Obesity and Metabolic Diseases reported that nearly 580,000 metabolic procedures were performed worldwide in 2014. The American Society for Metabolic and Bariatric Surgery estimated that 179,000 metabolic procedures were performed in the United States in 2013 and 196,000 were performed in 2015. The American Heart Association also recognizes the growing importance of these techniques. (1).

Non-Surgical Treatments

The goal of obesity treatment is to achieve and maintain a healthy weight. This improves overall health and reduces the risk of developing obesity-related complications.
Initially, the ideal is a modest weight loss: between 5 % and 10 % of your total weight. This means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would only need to lose about 10 to 20 pounds (4.5 to 9 kg) for your health to start improving. However, the more weight you lose, the greater the benefits.

All weight loss programs require changes in your eating habits and an increase in physical activity. The treatment methods that are right for you depend on the severity of your obesity, your general health, and your willingness to participate in the weight loss plan.

  • Cut calories
  • Feeling satisfied by eating less
  • Choose healthier options
  • Restrict certain foods
  • Food replacements

  • do exercise
  • keep on moving
  • Behavior changes

Behavior modification, sometimes called "behavior therapy," can include:

  • psychological counseling
  • Support groups
  • Prescription drugs for weight loss

Vagus nerve block is another treatment for obesity. It consists of implanting a device under the skin of the abdomen that sends intermittent electrical impulses to the abdominal vagus nerve, which signals to the brain when the stomach feels empty or full. This new technology was approved by the FDA in 2014 for use in adults who have not been able to lose weight with a weight loss program and who have a BMI between 35 and 45 and at least one obesity-related condition, such as type diabetes two.

Bariatric and Metabolic Surgery

Bariatric / metabolic surgery is the most effective and long-lasting treatment for severe obesity, resulting in significant weight loss and leading to improvement, prevention or resolution of many related diseases, including type 2 diabetes, heart disease, hypertension, sleep apnea and certain types of cancer (3) (4).