Cause of obesity
Problem of obesity
What is BMI?
What is morbid obesity?
Metabolic Syndrome
Options of weight reduction
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Option of Weight Reduction
The goal of weight-reduction therapy is to improve health by modifying obesity-related disease and
the risk for future obesity-related medical complications. Substantial weight loss with weight
maintenance has been shown to reduce markedly the prevalence of cardiovascular risk factors and
in most patients reverses diabetes, hypertension and pulmonary dysfunction.
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Dieting,
Exercise and Behavioral Modification
Conservative options such dieting combined with behavior therapy and exercise should be the
first line of therapy. However, for severely obese patients, conservative approach results
are disappointing. Among subjects whom successfully loss a substantial quantity of weight,
only 5-10% maintain the loss for more than a few years.
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Pharmacotherapy
Drug therapy, such as Orlistat (Xenical) and Sibutramine (Reductil), can also achieve a
substantial weight loss of about 10% of the excessive body weight. However, the use of
pharmacotherapy for obesity should considered as a short-term option, because patients
who respond to drug therapy usually regain weight when therapy is stopped. Nonetheless,
medical treatment of obesity may be successful when dealing with moderate obesity, overall
results of medical treatment for clinically severe obese patients are poor.
Sibutramine (Reductil)
 Serotonin / nonadenaline reuptake inhibitor
Inhibits food intake / appetite
May achieve 10% weight loss
Useful for maintenance of weight loss
May affect blood pressure
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Orlistat (Xenical)
Lipase inhibitor
Blocks fat digistion
9% weight loss (compared to 5% for diet alone)
Side effects unpleasant (uncontrol bowel motion)
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Surgery
Bariatric surgery, also known as weight loss surgery, refers to the various surgical
procedures performed to treat obesity by modification of the gastrointestinal tract to
reduce nutrient intake and/or absorption. Bariatric surgery is a surgery designed to
help patients with serious weight problems to achieve significant weight loss. It is
designed for patients who have a history of failed dieting attempts and a BMI exceeding
37 or 32 with diabetes or severe co-morbidities according to Asia-pacific guideline.
Patients who have bariatric surgery are usually between 18 and 60 years of age.
Bariatric surgery is an option to alleviate debilitating diseases caused by morbid obesity.
Patients who intend to undergo this surgery must be highly motivated and understand the risk
and long-term change of life style associate with the procedure. They must be able to adhere
to diet, exercise, and medical guidelines for the rest of their lives after surgery.
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