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More Than Just Diet and Exercise: Treating Obesity

Medically reviewed by Priti Parekh, MD, Susan Kerrigan, MD and Marianne Madsen on January 10, 2023

Obesity. It’s such a loaded word these days. The huge number of people who suffer with obesity is alarming, and the far reaching physical and mental health repercussions that it causes are devastating. 


But what’s really the problem anyway? Isn’t it just a matter of calories in versus calories expended? Reduce your calorie intake, increase your physical exercise, and spring back into a lean and trim body. Right? Science, however, disagrees. 


Dr. Fatima Cody Stanford, who teaches at Harvard Medical School and works at the Massachusetts General Hospital Weight Center, says that this kind of overly simplistic thinking combined with naming and shaming patients has actually contributed to the obesity epidemic. Stanford maintains that obesity is both a complex and chronic disease. It is governed by the relationship between how the body uses energy and how the body stores energy. It is also affected by the tangled interaction of genetic, developmental, hormonal, environmental, and behavioral factors. 


So if it’s not as simple as eating less and exercising more, what are some of the things we can do to treat obesity? 


Diet, exercise, and lifestyle


The first place to start is always improving one’s diet and exercise. The Massachusetts General Hospital Weight Center offers “Healthy Habits for Life,” an intense, individualized 12-week program aimed at educating patients and equipping them with the tools they need in order to lead a healthy lifestyle.The program emphasizes developing a healthy relationship with food, as opposed to the dreaded calorie counting. It promotes a diet rich in vegetables, fruit, lean protein, and whole grains.


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Obesity - Exercise

Obesity - Exercise

If a major lifestyle change hasn’t resulted in dramatic weight loss, other options to consider include weight loss medications, surgical intervention, and medical weight-loss devices. 


Weight loss medications don’t replace physical activity or healthy eating habits. But when combined with lifestyle changes, they can help with the arduous journey that is weight loss. These medications are not to be confused with pseudo-scientific herbs you can buy online or dangerous, untested teas you can buy which promise easy weight loss. Most of these medications are approved by the FDA only for adults, with the exception of Xenical, which is approved for children as young as 12. As with all other medications, there might be side effects, and they should only be taken under medical advice and supervision.


Last resort options to consider


No article on treating obesity would be complete without mentioning bariatric (weight loss) surgery. Bariatric surgery involves surgically tweaking your digestive system. Two types of people who suffer from obesity and would benefit from bariatric surgery are (1) people who suffer from extreme obesity and have tried to lose weight unsuccessfully and (2) people who are less obese but have serious health concerns related to their obesity such as sleep apnea and type 2 diabetes. Surgery is often considered as a last resort because it causes permanent changes to your body and, as with any invasive procedure, carries a certain level of risk. 


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Weight Loss Surgery - Procedure Options

Weight Loss Surgery - Procedure Options

New medical weight-loss devices including gastric electrical stimulation, gastric balloon, and gastric emptying systems such as the AspireAssist system. Gastric electrical stimulation works by using an implanted device to stimulate the stomach to empty. The gastric balloon system works by inserting a silicone-filled balloon in your stomach, limiting how much you can eat and making you feel fuller faster. The AspireAssist system involves implanting a drain into your stomach, which is then used to empty just under one-third your stomach contents after a meal. It is not designed as a permanent solution, and the patient needs frequent checkups to ensure that it is functioning properly and not causing other harmful side effects. Because these devices are relatively new, scientists have yet to do comprehensive research, so we currently don’t know all of the long-term effects. 


Even after undergoing these procedures and surgery, one doesn’t always lose significant weight or maintain one’s weight loss. Indeed, long-term success can only be achieved and maintained by making permanent lifestyle changes. 


Although obesity is a dangerous and devastating disease, both physically and mentally, it is heartening there are treatment options available to consider.


Written by Gila Isaacson

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