|
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
comprehensive weight 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)
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 obese patients, 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 combined restrictive/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.
For more easy to understand
guidelines:
|
