Obesity Management

What is Obesity?

Obesity, also called corpulence or fatness, is an excessive accumulation of body fat, usually caused by consuming more calories than the body can use. The excess calories are then stored as fat or adipose tissue.

Obesity is a complex health issue resulting from a combination of causes and individual factors such as behaviour and genetics. 

Behavioural Causes of Obesity

Behaviour that can lead to obesity include

• physical activity and inactivity, 
• dietary patterns, 
• medication use, and other exposures. 

Additional contributing factors include 

• the food and physical activity environment, 
• education and skills, and 
• food marketing and promotion.

How Common is Obesity?

Two-thirds of Australian adults are now overweight (35.6%) or obese (31.3%). Higher rates of men are overweight compared to women, while similar proportions of men and women are obese. 

The prevalence of overweight and obesity is rising in Australian adults, driven mainly by increased rates of obesity.

How is Obesity Measured?

Obesity is measured by measuring a person's Body Mass Index (BMI). BMI is a person's weight in kilograms divided by the square of height in metres. If your BMI is 25.0 to <30, it falls within the overweight range. 

If your BMI is 30.0 or higher, it falls within the obesity range. BMI screens for weight categories that may lead to health problems, but it does not diagnose an individual's body fatness or health.

What are the Health Impacts of Obesity?

Obesity is severe because it is associated with poorer mental health outcomes and reduced quality of life. Obesity is also associated with the leading causes of death worldwide, including diabetes, heart disease, stroke, and some types of cancer.

If you are concerned about your weight, Book an Appointment with our doctor to discuss your options for obesity management.

What is Obesity Management?

Obesity management refers to treating and caring for individuals living with obesity. This typically includes a combination of lifestyle changes, such as diet and exercise, and medical interventions, such as medication and weight loss surgery. 

The goal of obesity management is to help individuals lose weight and improve their overall health and well-being.

Effective obesity management often involves a multi-disciplinary approach, including

• input from doctors, 
• dietitians, 
• exercise physiologists, and 
• mental health professionals. 

Behavioural therapy and support groups can also help address the psychological and social aspects of obesity.

The treatment plan is designed to be individualised, considering the person's overall health, medical history, and personal preferences and goals. The ultimate goal is to help the person achieve a healthy weight and maintain it long-term.

Who Should Undergo Obesity Management?

Obesity management is typically recommended for individuals with a body mass index (BMI) of 30 or higher, which is considered obese. However, it may also be recommended for individuals with a BMI between 25 and 30 who have other health conditions related to their weight, such as diabetes or high blood pressure.

Individuals who are morbidly obese (BMI of 40 or higher) or those who have obesity-related complications such as sleep apnea, type 2 diabetes, high blood pressure, or cardiovascular diseases may also be recommended to undergo obesity management.

It's important to note that obesity management isn't just for adults, children and adolescents with obesity are also at risk of developing health problems and may benefit from weight management programs tailored to their age and developmental level.

Ultimately, the decision to undergo obesity management should be made in consultation with a healthcare provider, considering the individual's overall health, medical history, and personal preferences and goals.

What are the Benefits of Obesity Management?

Obesity management can have several benefits for individuals living with obesity. Some of the most notable benefits include:

• Weight loss: The most apparent benefit of obesity management is weight loss. Losing weight can help to improve overall health and reduce the risk of severe health conditions such as diabetes, heart disease, and stroke.
• Improved health: Obesity management can also help to improve several health conditions related to obesity, such as high blood pressure, diabetes, and sleep apnea.
• Increased energy levels: Losing weight can also increase energy levels and improve overall fitness, making it easier to perform daily activities.
• Improved self-esteem and mental health: Obesity can often lead to low self-esteem and depression. Losing weight through obesity management can help to improve self-esteem and mental health.
• Increased longevity: Obesity is associated with an increased risk of early mortality; managing obesity can improve overall lifespan.
• Reduced healthcare costs: Obesity management can reduce the need for medical treatment and healthcare costs in the long run.

Obesity management is a long-term process, and benefits may not be immediate, but with time, commitment and consistency, the individual can achieve and maintain a healthy weight.

What are the Types of Obesity Management?

There are several types of obesity management, which may be used alone or in combination, depending on the individual's needs and preferences. Some of the most common types of obesity management include:

• Lifestyle changes
• Medications
• Weight loss surgery
• Behavioural therapy

The choice of obesity management approach will depend on the individual's overall health, medical history, and personal preferences and goals. Working with your doctor to create a personalised treatment plan is essential.

Lifestyle Changes

Lifestyle changes are often the first line of treatment for obesity and are a vital component of obesity management. These changes typically include changes to diet and exercise and other habits and behaviours that may contribute to weight gain.

• Diet: Eating a healthy diet that is low in calories, saturated fat, and added sugars and high in fruits, vegetables, and lean proteins can help to promote weight loss and improve overall health. This can include reducing portion sizes, limiting processed foods, and increasing the intake of whole foods.
• Exercise: Regular physical activity is essential to weight loss and weight management. The American College of Sports Medicine recommends at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week and muscle-strengthening activities at least two days per week.
• Sleep: Obtaining good quality and enough sleep is essential for weight management. Chronic sleep deprivation can lead to hormonal imbalances that increase the risk of weight gain and obesity.
• Stress Management: Stress can lead to weight gain, so it's essential to manage stress levels through yoga, meditation, and deep breathing.
• Mindful eating: Mindful eating is an approach that encourages paying attention to the physical and emotional sensations of hunger and fullness, as well as the taste, smell, appearance and pleasure of food.
• Support system: Having a support system, such as a family member, friend, or support group, can help to provide motivation and encouragement for making lifestyle changes.

Lifestyle changes are a long-term commitment, but with time and effort, they can lead to sustainable weight loss, improved overall health and reduced risk of obesity-related health conditions.

Medications

Medications can be used as an adjunct to lifestyle changes to help individuals with obesity lose weight and improve overall health. The different types of medications used for obesity management include:

• Appetite suppressants: These medications reduce hunger and cravings, making it easier to stick to a reduced-calorie diet. Some examples of appetite suppressants include phentermine, diethylpropion, and phendimetrazine.
• Fat blockers: These medications work by preventing the absorption of fat from food. Orlistat is an example of a fat blocker.
• GLP-1 receptor agonists: These medications increase feelings of fullness and slow stomach emptying. Examples include liraglutide, semaglutide, and albiglutide.
• Bupropion-naltrexone: This combination reduces hunger and cravings and increases feelings of fullness.
• SGLT-2 inhibitors: These medications block glucose reabsorption in the kidneys, resulting in increased glucose excretion and weight loss. Examples include canagliflozin, dapagliflozin, and empagliflozin.

These medications are typically used with lifestyle changes such as diet and exercise and are not intended for long-term use. They should be used under the guidance of a healthcare provider, and regular monitoring is necessary. 

They also have potential side effects and drug interactions, so it's essential to inform your doctor of all medications and supplements being taken.

Weight Loss Surgery

Weight loss surgery, also known as bariatric surgery, is a treatment option for individuals with obesity who have not been able to achieve significant weight loss through lifestyle changes alone. These surgeries are typically recommended for individuals with a body mass index (BMI) of 40 or higher or for those with a BMI of 35 or higher and one or more obesity-related health conditions, such as diabetes or sleep apnea.

There are several types of weight loss surgery, including:

• Gastric bypass
• Sleeve gastrectomy
• Adjustable gastric banding
• Biliopancreatic diversion with duodenal switch (BPD/DS)

Weight loss surgery is an effective procedure that carries potential risks and complications, so it's essential for individuals to carefully consider the benefits and risks before deciding to have surgery. It's also important to note that weight loss surgery is not a quick fix, and individuals will need to make lifelong changes to their diet and exercise habits to maintain their weight loss.

Behavioural Therapy

Behavioural therapy is a type of therapy that focuses on helping individuals identify and change behaviours that contribute to their obesity. It can be an effective tool for individuals who want to lose weight and improve their health.

Some examples of behavioural therapy techniques that may be used for obesity management include:

• Cognitive-behavioural therapy (CBT)
• Motivational interviewing
• Mindfulness-based therapy
• Interpersonal therapy
• Problem-solving therapy

Behavioural therapy can be used alone or in combination with other treatments, such as diet, exercise, and medication. It typically requires more time and effort than other treatments, but it can be effective for long-term weight loss and maintenance.