Obesity: help with the problem with pharmaceuticals
A multidisciplinary approach has been advocated by healthcare professionals in order to achieve obesity help; in order to tackle the root of the problem. Pharmaceuticals have been prescribed to control and regulate the symptoms of obesity and specifically, sibutramine and orlista are routinely relied upon.
Siburamine has a dual function serving as an inhibitor of both serotonin and adrenergic reuptake and it has been identified as providing a rate of weight loss of 7.4kg per annum, so long as the drug was ingested according to the intake regime specified and recommended by the prescribing physician.
In effect, Orlistat is used to inhibit the absportion of fat that is contained within food when it passes through the digestive tract for digestion, breakdown and ultimate absorption. Orlistat has been identified as being capable of inhibiting the absorption of lipids during the process of digestion by approximately one-third (30%).
Phentermine happens to be the most commonly prescribed and well-known anti-obesity medications in the United States of America, although the FDA has been very quick to recommend that its usage for the management of obesity is strictly controlled and limited to a maximum duration of twelve weeks.
A major contributing reason as to the strictly enforced deadline with regards to Phentermine is that it is a sympathomimetic anorexogenic drug, which means that it artificially stimulates the digestive process thereby reducing and suppressing appetite.
Reported clinical findings that were concerned with the relative efficacy of this drug identified that it was capable of providing a rate of weight loss of 3.6kg when compared to a placebo.
Help with Obesity: surgical intervention
Surgery has been identified by health professionals as being the singularly most effective and long term method of ensuring that weight loss is ultimately achieved; this is due not only to the inherent mechanical differences that occur within the body but further, the psychological impact the surgery has on the obese patient as well.
It is imperative that the patient who is due to undergo such a procedure, or who is contemplating the possibility of doing so, is aware that this is not a cosmetic procedure at all and is designed solely for the treatment of the source of the problem. As such, the excess adipose tissue will not be excised or otherwise treated.
The effects of bariatric surgery
Bariatric surgery will involve the creation of a new gastric reservoir which is itself designed to serve as the new stomach; and the benefit of this newly created gastric reservoir is that it is physically capable of only holding smaller volumes of food. This in turn will trigger a sensation of physical fullness, meaning that the appetite is then suppressed.
It is also worth noting that results are not immediate, and according to the American Society for Metabolic and Bariatric Surgery (ASBMS) true weight loss will not be realized until 18 months to 2 years after the surgical procedure has been concluded.
Inherent risks of bariatric surgical intervention
Given the relatively traumatic nature of the procedure as well as the general poor health of the patients who receive it, there is always the risk of death although thankfully, the reported incidents of clinical mortality are fairly low.
Out of 38,501 patients, there were a total of 93 reported deaths that were identified as having arisen as a direct and causal relationship with the surgical procedure within a time frame of 30 days. In terms of statistical projections then, there is a median risk of mortality of 0.24% associated with this surgery. This is a direct consequence of the extremely stringent screening protocols employed by the surgical teams responsible for conducting this particular form of surgical procedure.
The vertical banded gastroplasty procedure is quickly falling out of favour and common usage as an effective clinical tool to control and regulate obesity, and the reason for this is due to the fact that even after the procedure has been performed, weight loss remains an ever elusive concept for the patient.
What of the ultimate results that can be accomplished with this procedure?
According to clinical findings reported by the ASBMS, the average degree of weight loss achieved by patients who underwent the gastric bypass surgical procedure was in the 48-74% range. This figure was reported at the 50-60% range for patients who had undergone the vertical banded gastroplasty.
Further investigation was conducted into the efficacy of the gastric bypass procedure in the long-term, and the results were overwhelmingly positive. The rate of weight loss achieved at the 50% mark even after the fourteenth year after the procedure had taken place.
Help with Obesity: Very low energy diets
A very low energy diet is another tool available in the treatment of obesity and it will involve the patient who is seeking to lose weight ingesting a series of concentrated and fortified drinks that although contain negligible amounts of calories within them (on average, 800kcal), will contain all of the essential nutrients, minerals and other dietary components necessary to maintain overall fitness and health.
Due to the nature of the typical very low energy diet, physicians will require that this procedure is strictly reserved for patients whose BMI is equal to or greater than 30. A BMI less than this figure is specified as being an absolute contraindication for the usage of the procedure.
The American Dietetic Association has been quick to provide a balanced and reasoned perspective of the procedure, identifying that although the initial results are promising with the potential for a reduction of 5% of the overall weight loss of the body to be achieved, these results ultimately taper off.
In 1998, an expert research committee from the National Heart, Lung and Blood Institution recommended that the reliance upon the very low energy diets should be mothballed forthwith, due to concerns over the rapid increase and recovery of the weight lost.
In short, there is a plethora of different methods of obesity help out there; and so a balanced decision must be made both by the patient undergoing such procedures and the physician responsible for their care.