Current Treatments for Obesity
In this article, we will examine the most common current treatments for obesity, and the pros and cons of each:
- Water pills
- Gastrointestinal liners
- Diet drugs and weight-loss supplements
Diuretics prompt the kidneys to excrete more water, causing a few pounds of weight loss - but only for a few hours. Additional concerns are that they also may cause serious dehydration and electrolyte imbalance.
Much debate has been heard about low-carb diets (Atkins, South Beach) and low-fat, high complex carb diets. Studies show that low-carb dieters tend to lose weight more quickly at first, but plateau at 6 months. They seem to lose more fat from their trunk, which body fat is normally associated with heart disease and diabetes. However, results after one year reveal that low-fat and low-carb diets reach essentially equal results.
One diet that many physicians currently approve of is the New Glucose Revolution Diet that distinguishes between good carbs (whole grains, nonstarchy vegetables, and fruits) and bad carbs (starches, sugary foods, and refined grains).
Some over-the-counter liquid high-protein diets contain such poor-quality protein that they are actually dangerous. The worst are those whose source is collagen protein instead of milk or soybean protein.
Last, but not least, is the good old Weight Watchers plan. It is recommended because it allows dieters to eat virtually any food, as long as it is within a certain point value.
A GI liner prevents food from contacting the first (approx) 20 inches of the intestinal wall, the upper part of the small intestine, including the duodenum and the first part of the jejunum. It is inserted through the mouth (not surgically). After insertion, nutrients are absorbed beyond the liner but in obviously reduced amounts.
Some people use this as their sole form of weight loss, and others use it to prepare for more drastic surgery such as GPS or BPD.
How a Gastrointestinal Liner is Inserted
Surgery is a more drastic option, but taking into consideration the risks versus the likelihood of weight loss and accompanying health improvement, serious research and discussion between you and your medical professional can help you make the right choice for your condition.
Current surgery options include:
- Stomach banding
- Gastric bypass surgery
- Biliopancreatic diversion (BPD)
Currently, stomach banding is a fairly non-intrusive surgery that laparoscopically (no big cuts) places a band around the stomach, thereby reducing its size and resulting in a feeling of fullness with less eating. The benefits of the band are that its location can be modified, or the band can be removed altogether. Unfortunately, many band patients instinctively find ways to work around the smaller stomach pouch (such as eating more frequently or eating higher fat and sugar foods) to regain the lost weight or settle at only a slightly lower weight than before the gastric banding.
Gastric Bypass Surgery (GBS)
GBS normally involves stapling of the stomach to reduce its size and surgery to bypass a large section of the intestines, resulting in a lower caloric and nutritional intake. A successful GBS (most common of which is a Roux-en-Y gastric bypass surgery (RGB), often results in dramatic weight loss in a relatively short period of time. There are, however, great risks involved in these types of surgeriesy as there are with BPD.
Biliopancreatic Diversion (BPD)
During BPD, a surgeon removes up to 2/3 of the stomach and cuts the small intestine in half, suturing one portion to the stomach opening, diverting pancreatic juice and bile away from the new intestine so that far fewer nutrients and no fats are absorbed. Patients can eat anything without gaining weight.
Successful BPD procedures remarkably affect weight loss and often restore health: blood pressure returns to normal, sleep apnea is reduced, and 86% of patients with Diabetes Type 2 are cured.
The down-sides of BPD include:
- Exceeding stomach capacity leads to the dumping syndrome (nausea and vomiting).
- BPD (and GB) surgery have been classified by the AMA as "severely dangerous" operations.
Liposuction can reshape your body by suctioning off fat deposits, but it's not really an option for losing weight, plus it carries with it the risk of surgery. Also, unless eating habits are changed, fat will just deposit itself in other parts of your body.
Diet Drugs and Weight-loss Supplements
Current popular weight-loss drugs include:
- phendimetrazine and diethylpropion
Phentermine is 1/2 of the fen-phen combination that caused heart attacks and deaths in the 1990's. Phentermine increases nervous system activity, raising blood pressure and heart rate and decreasing hunger. Because many overweight people have high blood pressure and are at risk for heart issues, this drug is obviously not a wise choice and requires close and frequent medical supervision. In addition, when a patient discontinues use of Phentermine, in almost all cases, the hunger and weight return.
Phendimetrazine and Diethylpropion
These drugs work in a similar amphetamine-like way, also stimulating the nervous system to increase heart rate and blood pressure and reduce hunger. These drugs also require close medical supervision and the effects tend to wear off quickly, with hunger and weight returning to the starting point or even higher.
Orlistat interferes with pancreatic lipase so that part of the fat you eat is not digested or absorbed, along with fat-soluble vitamins. If taken properly, this drug can help with modest weight loss, but side effects often include diarrhea and anal leakage. It also may cause severe liver damage.
Several over-the-counter weight loss supplements that claim to boost metabolism and burn calories are proving very dangerous. Lawsuits due to deaths, strokes, seizures, liver failure, and severe headaches abound, especially among drugs that contain Ephedra or usnic acid.
Hope for the Future
Currently there are a number of drugs being developed that act at several different CNS (Central Nervous System) sites, including neuropeptide Y inhibitors. See: Why am I so Fat? A Biological Perspective.
Also, animal studies have shown that activating brown fat counteracts weight gain and Type 2 Diabetes.
In the meantime (how many times have we heard this?), the only realistic ways to lose weight are to eat healthier meals (no starving or fasting) and increase our activity levels.
However, there is a trend among doctors to start treating patients more holistically, using a biopsychosocial (mind-body) model, recognizing that all of these forces act together to determine a person's health. Some practitioners are taking the time to develop realistic plans for weight loss with their patients instead of just treating the diseases that develop due to being overweight. So, seek out a health care professional who is willing to be more proactive in helping you achieve your weight-loss goals.