Obesity is defined as an excess proportion of total body fat. According to the Center for Disease Control and Prevention, more than one-third of U.S. adults and 17% of U.S. children are obese. From 1980 through 2008, obesity rates doubled for adults and tripled for children. The potential health implications for these trends are frightening. Whereas many recognize the significant risk of cardiovascular disease and diabetes associated with excess body fat, they do not realize that there is a multitude of health problems that can accompany obesity—cancer (such as endometrial, breast, and colon), high blood pressure, high cholesterol, stroke, sleep apnea, and even reproductive health complications. As a result there is urgency among health professionals to fight this epidemic.
Diet and exercise should be the first steps to setting successful weight loss goals. Consuming foods that are low in fat and sugar and increasing dietary fiber should become part of a person’s lifestyle along with regular physical exercise. A person should exercise five times a week for at least 30 minutes. There are plenty of over the counter medications that claim to promote weight loss; however, these should be used cautiously because they are not recommended in certain disease states. They also tend to include a number of side effects such as increases in blood pressure, palpitations, nervousness, and sleeplessness. If over the counter products are used, make sure you always consult your doctor if you have any chronic condition.
There are also prescription medications for the treatment of obesity that are available for patients who have certain risk factors. Phentermine reduces appetite by stimulating the central nervous system. It is only indicated as short term treatment and should be used with caution in patients with cardiovascular conditions because it can increase blood pressure and heart rate. Sibutraime also works by decreasing appetite. It can be used up to 2 years, but patients with cardiovascular disease have an increased risk of having a heart attack while on this medication. Orlistat works by preventing fat absorption in the stomach and is associated with some unpleasant side effects such as oily spotting, fecal urgency, and flatulence. Recent studies have also shown increased risk of liver disease with the use of Orlistat.
Once all pharmacological options have been exhausted, a patient can then consider surgery. Currently, the three major types of procedures are stapled gastroplasty, adjustable gastric banding, and conventional Roux-en-Y gastric bypass; however, because of related morbidity and mortality, these interventions should be reserved for those with a body mass index greater than 40kg/m2 or 35kg/m2 and significant risk factors.
Patients seeking help for obesity do so for many reasons including an improvement in quality of life, a reduction in associated morbidity, and to prolong life. Yet numerous individuals seek therapy for obesity primarily for cosmetic purposes and often have unreasonable goals and expectations. Remember that there is no magic pill or method that will give you weight loss results in one day. Weight loss takes time, discipline, and a commitment to live a healthier life. Whatever your weight loss goals may be for 2011, make sure you consult with your doctor about the options that fit with your specific weight loss goals.
By Aimee Villalon, Doctor of Pharmacy