Treatment of obesity. A review of selected guidelines

Abstract

Treatment of obesity is one of the challenges of the 21st century. It is a risk factor for the development of other diseases such as hypertension, coronary heart disease and cancer. The diagnosis of obesity should be based on body mass measurements, taking into account height and sex. It is also recommended to measure waist and hip circumference. Lifestyle modifications, which include increased physical activity and reduced calorie intake, are the primary method of treating obesity. Unfortunately, changing habits is difficult and even unattainable for many patients. Due to the increasing prevalence of obesity in the society, this review of guidelines is addressed to general practitioners and all physicians who encounter obese patients in their practice. Each of the guidelines analysed emphasises prevention, early diagnosis, and treatment of obesity. Behavioural and dietary changes are central in obesity management. The guidelines also point to the role of effective doctor–patient communication, as well as the need for a multidisciplinary management of obesity by a team composed of a physician, dietitian, and often physiotherapist. Pharmacotherapy, which was introduced in recent years as a supportive treatment, is another pillar of obesity therapy. Therefore, we also reviewed guidelines regarding pharmacological treatment of obesity. We focused on summarising indications for anti-obesity medications, descriptions of individual medications, their dosing regimens, as well as therapeutic goals, pointing out differences between individual recommendations.