According to the World Health Organization, by 2015 2.3 billion adults will be overweight, and more than 700 million will be obese.
Weight-loss medications may be recommended for patients who are at increased medical risk because of their obesity. Most research-based and professional associations recommend lifestyle therapy for at least six months before embarking on a weight-loss plan using physician-prescribed drug therapy. Even then, it must be used only as part of a comprehensiveweight loss program that includes dietary therapy and physical activity. Currently available prescription medications include:
* Phentermine (Adipex, Fastin, Ionamin, Oby-trim)
* Diethylpropion (Tenuate, Tenuate dospan, Tepanil)
* Mazindol (Sanorex, Mazanor)
* Phendimetrazine (Adipost, Bontril, Plegine, Prelu-2, X-Trozine)
* Benzphetamine (Didrex)
* Sibutramine (Meridia)
* Orlistat (Xenical)
*Qsymia(combination of phentermine and topirimate.)
*Belviq(approved in June 2012)
Weight-loss drugs have a mixed track record with the FDA. Fenfluramine -- commonly known as fen-phen -- was pulled from the market in 1997 because of its association with heart valve disease. Accutrim was removed in 2000 because of its association with strokes. And Meridia production ceased in 2010 due to concerns of heart disease and strokes.
Most of these appetite-suppressants have been approved 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 obesepatients, although the safety and effectiveness have not been established for use beyond one year. Most of these drugs decrease appetite by affecting levels of the brain neurotransmitters catecholamine, serotonin and/or noradrenaline -- brain chemicals that affect mood and appetite. Orlistat (Xenical) does not act directly on the central nervous system but inhibits an enzyme essential to fat digestion. In general, these medications are modestly effective, leading to an average weight loss of five to 22 pounds above that expected with non-drug obesity treatments.
If you are, may be or could become pregnant or are nursing, be sure to tell your healthcare professional. The effects of most of these drugs have not been tested on unborn babies; however, medications similar to some of the short-term appetite-suppressants have been shown to cause birth defects when taken in high doses. Also, diethylpropion and benzphetamine pass into breast milk.
You also will need to tell your health care professional about any existing medical problems before taking these medications, especially thyroid problems, anxiety disorders, epilepsy or other seizure disorders, diabetes, heart disease, high blood pressure, arteriosclerosis, or glaucoma. Also, your healthcare professional needs to be aware of any other medications you are taking or have taken within the last 14 days, especially monoamine oxidase inhibitors (MAOIs) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil). Mention any existing or previous problems with alcohol or drug abuse as well. Side effects of anti-obesity drugs can range from mild to serious and should be discussed in detail with your health care professional before making a decision to use these medications.
Surgical treatment : For clinically severe obesity, surgery may be an element of treatment. Many people, some physicians included, wrongly believe that obese people merely need to stop eating so much and they will lose weight. In reality, severe obesity is a potentially deadly disease that sometimes requires a treatment as dramatic as surgery.
There are two types of obesity surgery — restrictive and combinedrestrictive/mal-absorptive. Different ways of performing each surgery have been developed. Each type of surgery has its own risks and side effects. Your physician can help you decide which is best for you.
Wiring the jaws together to prevent eating has been used to treat those who have found it impossible to adhere to low-energy diet. These can help patients to achieve remarkable weightloss, but most patients regain weight when the procedure is reversed. Another major surgery involves the reduction in size of the stomach for example by stapling which can be undone. Small intestine bypass aimed at inducing mal-absorption, has been undertaken in some centers for treatment of severe "morbid" obesity but complications can be severe and sometimes fatal. Surgery should be considered only for those with gross, intractable obesity. To know more about the various surgical procedures log on to http://www.medscape.com.
NOTE: Successful weightloss does not depend on operation, drugs, injections, fad diets or other manipulation undertaken by the therapist, rather it depends on the ability of the patient to manage the disorder herself and to persist indefinitely with some restrictions on dietary freedom.