Dietary Counseling and Behavior Modification.
- Caloric restriction has been successful in short-term weight loss, but less so over the long term.
- Patients who receive counseling on low-calorie diets (1000-1200 Calories daily) achieve an 8% loss of body weight over 12 months.
- Very low calorie diets have similar long-term results.
- Low fat diets are no more effective than calorie restricted diets.
- There is insufficient evidence to advise against or for the use of low carbohydrate diets.
Dietary Guidelines
Weight Loss for Life
Weight Loss for the Morbidly Obese
Medications
- There are FDA approved medications available for the treatment and management of obesity.
- These are prescription only medications and are given under the supervision of a physician.
- These are approved for patients with a BMI of 30 and above or for patients with hypertension, diabetes or elevated cholesterol, a BMI of 27 and above.
Surgery
- Patients meeting certain criteria are referred for Bariatric Surgery.
- Surgical therapy for obesity is called Bariatric Surgery.
- Surgery is indicated in patients, who are morbidly obese, BMI of 40 and above or in patients with hypertension, diabetes and elevated cholesterol, a BMI of 35 and above.
- Surgery is more effective that non-surgical treatment for weight loss and control of some co-morbid conditions for morbidly obese persons.
- Death rate within 30 days of surgery ranges from 0.1% to 1.1% depending on the procedure.
- Complications include leaks at the bypass site, wound infections and breakdown, heart and lung failure, heart attacks, pneumonia and blood clots in the blood vessels of the lungs.
- The American College of Physicians recommends surgery for patients with a BMI of 40 and above, who have failed an exercise and dietary program.