Obesity management: what brings success?

Abstract

Abstract:The upward trend in obesity prevalence across regions and continents is a worldwide concern. Today a majority of the world's population live in a country where being overweight or obese causes more deaths than being underweight. Only a portion of those qualifying for treatment will get the health care they need. Still, a minor weight loss of 5-10% seems to be sufficient to provide a clinically significant health benefit in terms of risk factors for cardiovascular disease and diabetes. Diet, exercise and behavior modifications remain the current cornerstones of obesity treatment. Weight-loss drugs play a minor role. Drugs which were available and reasonably effective have been withdrawn because of side effects. The fact that the 'old' well known, but pretty unexciting tools remain the basic armamentarium causes understandable concern and disappointment among both patients and therapists. Hence, bariatric surgery has increasingly been recognized and developed, as it offers substantial weight loss and prolonged weight control. The present review highlights the conventional tools to counter obesity, lifestyle modification, pharmacotherapy and bariatric surgery, including some of the barriers to successful weight loss: (1) unrealistic expectations of success; (2) high attrition rates; (3) cultural norms of self-acceptance in terms of weight and beliefs of fat being healthy; (4) neighborhood attributes such as a lack of well-stocked supermarkets and rather the presence of convenience stores with low-quality foods; and (5) the perception of the neighborhood as less safe and with low walkability. Prevention is the obvious key. Cost-effective societal interventions such as a tax on unhealthy food and beverages, front-of-pack traffic light nutrition labeling and prohibition of advertising of junk food and beverages to children are also discussed.

Dietary advice on prescription: experiences with a weight reduction programme

“…A number of participants, who had high expectations that they would receive more and better support than they had previously, due to the programme being managed by healthcare professionals, may have had unrealistic goals and expectations that were too high. This is not uncommon and is supported by other studies (Lagerros & R€ ossner 2013).…”

Obesity in CKD—What Should Nephrologists Know?

“…16 Because the overweight prevalence growth rate is higher in individuals who are less educated and have low socioeconomic status, the social disparities represent important risk factors for obesity-related chronic diseases in developing countries. 17 …”

‘Change means sacrificing a good life’: perceptions about severity of type 2 diabetes and preventive lifestyles among people afflicted or at high risk of type 2 diabetes in Iganga Uganda

“…A major shift in the health systems of low income countries is therefore necessary, to integrate prevention for non-communicable diseases [2, 3]. Personal lifestyle factors to reduce risk of type 2 diabetes have been known for decades [4–6]. They include: Healthy diets, physical activity and regular check-ups on health parameters (body weight, blood sugar, blood pressure, blood lipids, and adherence to therapy) [7, 8].…”