Lifestyle Modification Remains Number One Aspect Of Obesity Treatment


The world may recover from the deadly COVID-19 pandemic, but the ever-existing pandemic of Obesity may not end very soon. World over, including in India, the percentage of the obese population has increased at an alarming rate. The World Health Organization (WHO) states that the obese population has tripled since 1975, and close to 50 per cent of the world’s population is either overweight or obese.

Obesity also brings along many life-threatening diseases like Diabetes, Hypertension, High Cholesterol, Polycystic Ovarian Disease (PCOD), Osteoarthritis, heart disease and cancers. Dr Sharad Sharma, Consultant Robotic, Laparoscopic GI and Bariatric Surgeon, Hiranandani Hospital, Vashi – A Fortis Network Hospital shares options for losing weight and leading a healthier life. 

DIET AND EXERCISE: There is a long list of formula diets that have been used for many years with limited success. Activity boosters and calorie burners like exercise, Yoga, etc. also have a role in achieving and maintenance of weight loss. Diet, exercise, and lifestyle modification will remain an important achievable methods for most of us.

MEDICAL THERAPY: People who are unable to achieve adequate long-lasting weight loss, or also have co-morbidities like Diabetes and have a Body Mass Index of up to 30 Kg/m2, can be prescribed medications for weight loss. Drugs for weight loss have been around for more than three decades and many were used off-label initially. One interesting group of the formulation is the GLP-1 Analogue. They act like the naturally present Glucagon-like Peptide-1 but have a stronger action. They were initially available as daily injections (Liraglutide), later as once-weekly injections (Semaglutide), and recently the oral version of the Semaglutide has been launched (Rybelsus by Nova Nordisk). All the drugs which are prescribed for weight loss have a variable effect, and strict diet protocols need to be followed. The drugs need to be stopped if no satisfactory weight loss is observed within two months of the therapy, or if the medication is poorly tolerated. Most of the medications are short term prescription drugs. The introduction of Semaglutide has been deemed as a game-changer, but only time will tell.

INTERVENTIONS: Minimally invasive procedures like the Intragastric Balloon have become more attractive with the introduction of the long-term balloon (Spatz), Swallowable Balloon pill (Obalon) and the self-deflating Intragastric Balloon (Elipse). A newly introduced endoscopic procedure known as ‘Endoscopic Gastric Sleeve’ has also emerged as an attractive option. One should know that all these implants and procedures are expensive, also results are limited and at best temporary unless followed by lifestyle modifications.

BARIATRIC SURGERY: Bariatric surgery remains the most effective weight loss procedure for morbidly obese patients (BMI >35). Bariatric surgical procedures like the Laparoscopic Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and the Mini Gastric Bypass remain the more commonly performed bariatric operations. Bariatric surgery not only gives significant weight loss and long-term weight maintenance, but it also cures many co-morbid conditions like Type 2 Diabetes, Dyslipidaemia, Obstructive Sleep Apnea (OSA), Fatty Liver Disease, Polycystic Ovarian Disease (PCOD), and Osteoarthritis.

One must realize that whatever medication or procedure one chooses for weight loss, lifelong lifestyle modification will still be the most important consideration for overall health and happiness.

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