Management of obesity

Obesity is increasing in urban areas of India, and constitutes most important factor for development of the metabolic syndrome and diabetes. Long-term management with weight loss is the key component for successful management of the problem. Non-pharmacological management through diet, physical activity, and behavior modifications is the first step and most important step. However, if it fails, pharmacological treatments with drugs are advised. Orlistat, sibutramine, and rimonabant are effective weight loss drugs. However, weight is often regained once these drugs are withdrawn. Orlistat and sibutramine have FDA recommendation, while rimonabant is awaiting approval. Lastly, the patients suffering from morbid obesity and with a very high BMI need surgical intervention. Rational application of these therapies, along with behavioral modification, should lead to significant weight loss and weight loss maintenance.