Overweight and Obesity Treatment
If you are diagnosed with overweight or obesity, you and your healthcare provider will work together to develop a treatment plan. Your plan will likely include reducing the number of calories you eat each day, getting more physical activity, and adopting lifelong healthy lifestyle changes.
The goal of your treatment plan is to reduce your risk of obesity-related complications and improve your quality of life. Depending on your body mass index (BMI) and other health conditions you have, your provider may also talk to you about dietary or nutritional counseling, behavioral weight-loss treatment programs, medicines, or surgery. The obesity screening, counseling, and weight-loss programs may be covered by your insurance.
Healthy lifestyle changes
To help you aim for and maintain a healthy weight, your provider may recommend that you adopt lifelong healthy lifestyle changes. A 5% to 10% weight loss can significantly improve your health and quality of life.
- Choose heart-healthy foods. It’s important to eat the right number of calories to maintain a healthy weight. If you need to lose weight, try to reduce your total daily calories gradually. Use the DASH Eating Plan to find out your daily calorie needs and to set goals. View healthy recipes and plan for success. Talk with your provider before beginning any diet or eating plan.
- Get regular physical activity. Many health benefits are associated with physical activity and getting the recommended amount of physical activity needed each week. Before starting any exercise program, ask your provider about what level of physical activity is right for you.
- Get enough good-quality sleep. NHLBI research has shown a relationship between lack of sleep and obesity that begins as early as infancy. Experts recommend 7 to 8 hours of sleep per night for adults. See the recommended hours for children at every age.
Behavioral weight-loss programs
Research has shown that there are areas of your brain that respond to pleasure. A chemical messenger is released whenever this part of the brain is stimulated by something we enjoy, such as eating food. The stimulation makes us feel good. Research shows that these connections may be stronger in some people than in others, which may explain why some people have a harder time losing weight.
Individual or group behavioral weight-loss programs are run by people who understand these brain connections. In these programs, one or more trained healthcare professionals, such as a registered dietitian and nutritionist (RDN), psychologist, or exercise physiologist, will work with you to develop a customized weight-loss plan. The plan will likely include a reduced-calorie diet, physical activity goals, and behavioral strategies to help you make and maintain these lifestyle changes.
Your weight-loss specialist usually reviews or modifies your goals every 6 months, based on your progress and overall health.
When you are choosing a behavioral weight-loss program, you may want to consider whether the program:
- Offers the service of multiple professionals, such as registered dietitians, doctors, nurses, psychologists, and exercise physiologists
- Provides goals that have been customized for you and that consider things such as the types of food you like, your schedule, your physical fitness, and your overall health
- Provides individual or group counseling to help you change your eating patterns and personal unhealthy habits
- Teaches long-term strategies to deal with problems that can lead to future weight gain, such as stress or slipping back into unhealthy habits
Other things to consider when selecting a program include:
- How many people have successfully completed the program
- The average weight loss for people who finish the program
- Possible side effects or risks
- Fees or costs for additional items, such as dietary supplements
Medicine
When healthy lifestyle changes are not enough, your provider may treat overweight and obesity with medicines. The Food and Drug Administration (FDA) has approved several medicines for weight loss or management. These medicines target different parts of your body.
- Brain: Several medicines change the way the brain regulates the urge to eat, reducing your appetite. These include liraglutide, which is now approved for both children and adults age 12 or older with obesity. Other medicines that work in a similar way are naltrexone/bupropion, diethylpropion, and phendimetrazine. Setmelanotide is used to treat rare genetic conditions that cause obesity and increases resting metabolism.
- : Orlistat blocks your intestines from absorbing fat from foods in your diet.
- Pancreas: Semaglutide is an injectable medicine that works by helping the pancreas release the right amount of insulin when blood sugar levels are high. Insulin helps move sugar from the blood into other body tissues, where it is used for energy. The injections also work by slowing the movement of food through the stomach and may reduce appetite and cause weight loss.
Weight-loss medicines are not recommended as a single treatment for weight loss. These medicines can help you lose weight but should be combined with lifestyle changes for greater and longer-lasting weight loss.
Tell your provider about all the medicines you take, because some of these medicines should not be used if you have certain conditions or are taking certain other medicines. Also, these medicines may have side effects. Talk to your provider if you are pregnant, planning to get pregnant, breastfeeding, or have a family history of cardiovascular conditions, such as high blood pressure, heart attack, or stroke.
Devices
The FDA has approved three weight-loss devices for adults. About half the people who undergo procedures to implant these devices lose at least 5% of their initial body weight as a result of the devices.
- Gastric balloons are placed in the stomach via a swallowable capsule attached to a thin catheter or via an endoscope (a long flexible tube with a small camera and a light at the end). Then, depending on the device, the balloons may be filled with gas or liquid (such as salt water) and sealed. Later, they are removed.
- Gastric bands are surgically implanted around the stomach, limiting the amount of food a person can eat at one time and increasing digestion time. This helps people eat less.
- Gastric emptying systems include a tube placed in the stomach via an endoscope and a port that lies against the skin of the abdomen. The tube drains a portion of the stomach contents into a container 20 to 30 minutes after meals. The device is removed when the patient reaches their goal weight.
Your doctor will monitor you for pain, vitamin deficiencies, anemia, persistent nausea and vomiting, intolerance to solid food, and failure to lose weight. These complications can be treated if they occur.
Surgery
Some people do not lose weight by making healthy lifestyle changes or taking medicines. If your BMI is 35 or greater and you are at risk for obesity-related complications, you may be eligible for surgery if you develop obesity-related complications.
Types of weight-loss (also called bariatric) surgeries are listed below.
- Gastrectomy: A big portion of the stomach is removed to reduce the amount of food that you can eat.
- Gastrectomy: A big portion of the stomach is removed to reduce the amount of food that you can eat.
- Gastric banding: The gastric band mentioned above is placed around the upper part of the stomach. This creates a smaller stomach.
- Gastric bypass surgery: A small part of the stomach is connected to the middle part of the intestine, bypassing the first part of intestine. This reduces the amount of food that you can eat and the amount of fat your body can take in and store.
Talk to your doctor to learn more about the benefits and risks of each type of surgery. All surgeries carry some type of risk of possible complications, including bleeding, infection, or even death.