The Therapeutic Aspects of Obesity

Abstract

The prevalence of obesity has increased worldwide, reaching pandemic levels. More than half of the world’s population will be overweight or obese by 2035 without significant action, according to a report of the World Obesity Federation’s. The World Health Organization defines overweight as body mass index (BMI) >25 kg/m2 and obesity >30 kg/m2 and describes these conditions as abnormal or excessive fat accumulation that is associated with increased health risk. Epidemiologic studies have revealed an association between high BMI and an extensive range of chronic diseases such as non alcoholic fatty liver disease, cardiovascular diseases, diabetes mellitus, several malignancies, musculoskeletal diseases, chronic kidney disease, and mental disorders, which consequently, affect negatively subjects’ quality of life and raise healthcare costs. Obesity as a chronic and progressive lifelong disease requires an active approach to treatment. For obese persons, it is recommended that a diet with an energy deficit of 500 kcal/day and a low energy density should be instituted for the purpose of weight loss and stabilization of a lower weight. More physical exercise in everyday life promotes weight loss and improves risk factors and obesity-associated diseases. Behavior modification and behavioral therapy support changes in nutrition and exercise in everyday life. Pharmacotherapy for obesity can be considered if patients have a BMI of 30 kg/m2 or greater or BMI of 27 kg/m2 or greater with weight-related comorbidities. The choice of the anti-obesity medication needs to take into consideration the patient’s clinical and biochemical profile, co-morbidities, and drug contra-indications, as well as expected degree of weight loss and improvements in cardio-renal and metabolic risk. Successful therapy for obesity depends on tailoring treatment to patients’ behaviors and comorbidities and monitoring of efficacy, safety, and tolerability.