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There are no medications currently approved for the treatment of obesity in children. The American Academy of Pediatrics recommends medications for obesity be discourage. Orlistat and sibutramine may be helpful in managing moderate obesity in adolescence. Metformin is minimally useful. A Cochrane review in 2016 concluded that medications might reduce BMI and bodyweight to a small extent in obese children and adolescents. This conclusion was based only on low quality evidence.
The main treatment for obesity consists of dieting and physical exercise. Diet programs may produce weight loss over the short term, but maintaining this weight loss is frequently difficult and often requires making exercise and a lower food energy diet a permanent part of a person's lifestyle.
In the short-term low carbohydrate diets appear better than low fat diets for weight loss. In the long term; however, all types of low-carbohydrate and low-fat diets appear equally beneficial. A 2014 review found that the heart disease and diabetes risks associated with different diets appear to be similar. Promotion of the Mediterranean diets among the obese may lower the risk of heart disease. Decreased intake of sweet drinks is also related to weight-loss. Success rates of long-term weight loss maintenance with lifestyle changes are low, ranging from 2–20%. Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve outcomes for both the mother and the child. Intensive behavioral counseling is recommended in those who are both obese and have other risk factors for heart disease.
Five medications have evidence for long-term use orlistat, lorcaserin, liraglutide, phentermine–topiramate, and naltrexone–bupropion. They result in weight loss after one year ranged from 3.0 to 6.7 kg over placebo. Orlistat, liraglutide, and naltrexone–bupropion are available in both the United States and Europe, whereas lorcaserin and phentermine–topiramate are available only in the United States. European regulatory authorities rejected the latter two drugs in part because of associations of heart valve problems with lorcaserin and more general heart and blood vessel problems with phentermine–topiramate. Orlistat use is associated with high rates of gastrointestinal side effects and concerns have been raised about negative effects on the kidneys. There is no information on how these drugs affect longer-term complications of obesity such as cardiovascular disease or death.
The most effective treatment for obesity is bariatric surgery. The types of procedures include laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, vertical-sleeve gastrectomy, and biliopancreatic diversion. Surgery for severe obesity is associated with long-term weight loss, improvement in obesity related conditions, and decreased overall mortality. One study found a weight loss of between 14% and 25% (depending on the type of procedure performed) at 10 years, and a 29% reduction in all cause mortality when compared to standard weight loss measures. Complications occur in about 17% of cases and reoperation is needed in 7% of cases. Due to its cost and risks, researchers are searching for other effective yet less invasive treatments including devices that occupy space in the stomach.
Obesity in children is treated with dietary changes and physical activity. Dieting and missing meals should; however, be discourage. The benefit of tracking BMI and providing counselling around weight is minimal.
Weight management has two steps: weight loss and weight maintenance. In the weight loss phase, energy intake from food must be less than the energy expended each day. Achieving weight loss in cats and dogs is challenging, and failure to lose weight is common.
Medical treatments have been developed to assist dogs in losing weight. Dirlotapide (brand name Slentrol) and mitratapide (brand name Yarvitan) were authorized for use in the EU by the European Medicines Agency for helping weight loss in dogs, by reducing appetite and food intake, but both of these drugs have been withdrawn from the market in the EU. The US Food and Drug Administration approved dirlotapide in 2007. Up to 20% of dogs treated with either dirlotapide or mitratapide experience vomiting and diarrhea; less commonly, anorexia may occur. When these drugs are stopped, the dog's appetite returns to previous levels. If other weight-loss strategies are not employed, the dog will again gain weight.
Although there are many short- term preventative methods in place to combat childhood, there are some individuals who return to their initial base weight and therefore might turn to surgical measures to achieve a more lasting effect. Bariatric surgery is an effective procedure used to restrict the patients food intake and decrease absorption of food in the stomach and intestines. Proecdures of this type are said to be able to reduce excess body weight of obese or overweight individuals by 50-75%, ultimately maintaining this weight loss for 16 years following.
The usual treatments for overweight individuals is diet and physical exercise.
Dietitians generally recommend eating several balanced meals dispersed through the day, with a combination of progressive, primarily aerobic, physical exercise.
Because these general treatments help most case of obesity, they are common in all levels of overweight individuals.
There are many options available in treating obesity, such as: altering one's diet and exercising regularly. Moderate forms of exercise, such as walking, can lead to healthy weight loss. Some people who are obese turn to gastric bypass surgery in order to reduce their appetites. It is always advised to consult a physician regarding any obesity treatment.
It is recommended that obese women should try to lose weight before becoming pregnant, yet women should not diet during pregnancy because sufficient nutrition is important for pregnant women and women planning pregnancy. Women with gastric banding can have normal pregnancies and better outcomes than women who do not have the surgery, but in most cases, doctors have agreed that pregnancy should wait until surgery-related weight loss has stabilized. Clinicians have been encouraged to talk to women who are pregnant or may become pregnant about getting enough folic acid, quitting smoking, and avoiding alcohol. Women are also recommended to have appropriate calorie intake and exercise adequately.
During pregnancy, doctors recommend light exercise. Doctors state that exercise can help the comfort of the mother and the well-being of the unborn child. Some benefits include, but are not limited to: reduced back pain, decrease in constipation, less likely to gain excess weight, decreased chance of gestational diabetes, easier labor, quicker recovery, and better physical and emotional health of the baby.
If negative signs and symptoms occur after exercising, pregnant females should stop immediately. Some signs include: dizziness, faintness, headache, shortness of breath, uterine contractions, vaginal bleeding, fluid leaking, or heart palpitations.
A permanent routine of exercise, eating healthily, and, during periods of being overweight, consuming the same number or fewer calories than used will prevent and help fight obesity. A single pound of fat yields approximately 3500 calories of energy (32 000 kJ energy per kilogram of fat), and weight loss is achieved by reducing energy intake, or increasing energy expenditure, thus achieving a negative balance. Adjunctive therapies which may be prescribed by a physician are orlistat or sibutramine, although the latter has been associated with increased cardiovascular events and strokes and has been withdrawn from the market in the United States, the UK, the EU, Australia, Canada, Hong Kong, Thailand, Egypt and Mexico.
A 2006 study published in the International Journal of Sport Nutrition and Exercise Metabolism, suggests that combining cardiovascular (aerobic) exercise with resistance training is more effective than cardiovascular training alone in getting rid of abdominal fat. An additional benefit to exercising is that it reduces stress and insulin levels, which reduce the presence of cortisol, a hormone that leads to more belly fat deposits.
Self-motivation by understanding the risks associated with abdominal obesity is widely regarded as being far more important than worries about cosmetics. In addition, understanding the health issues linked with abdominal obesity can help in the self-motivation process of losing the abdominal fat. As mentioned above, abdominal fat is linked with cardiovascular disease, diabetes, and cancer. Specifically it's the deepest layer of belly fat (the fat you cannot see or grab) that poses health risks, as these "visceral" fat cells produce hormones that can affect health (e.g. increased insulin resistance and/or breast cancer risk). The risk increases considering the fact that they are located in the proximity or in between organs in the abdominal cavity. For example, fat next to the liver drains into it, causing a fatty liver, which is a risk factor for insulin resistance, setting the stage for Type 2 diabetes.
In the presence of diabetes mellitus type 2, the physician might instead prescribe metformin and thiazolidinediones (rosiglitazone or pioglitazone) as antidiabetic drugs rather than sulfonylurea derivatives. Thiazolidinediones may cause slight weight gain but decrease "pathologic" abdominal fat (visceral fat), and therefore may be prescribed for diabetics with central obesity.
Thiazolidinedione has been associated with heart failure and increased cardiovascular risk; so it has been withdrawn from the market in Europe by EMA in 2010.
Low-fat diets may not be an effective long-term intervention for obesity: as Bacon and Aphramor wrote, "The majority of individuals regain virtually all of the weight that was lost during treatment." The Women's Health Initiative ("the largest and longest randomized, controlled dietary intervention clinical trial") found that long-term dietary intervention increased the waist circumference of both the intervention group and the control group, though the increase was smaller for the intervention group. The conclusion was that mean weight decreased significantly in the intervention group from baseline to year 1 by 2.2 kg (P<.001) and was 2.2 kg less than the control group change from baseline at year 1. This difference from baseline between control and intervention groups diminished over time, but a significant difference in weight was maintained through year 9, the end of the study.
School nurses in Uppsala, Uppsala County will be prescribing exercise to teenage boys. The prescribed exercise can be anything from participating in a sport to walking. Spaces will be available for the participants.
The two most common forms of treatment that are crucial for individuals to carry out to combat obesity include changing to a healthier diet and increasing their physical exercise. In extreme cases, if children are morbidly obese bariatric surgery may be carried out.
An appropriate weight training and weight loss program can help to improve the patient's condition.
Compared to non-obese animals, obese dogs and cats have a higher incidence of osteoarthritis (joint disease) and diabetes mellitus, which also occur earlier in the life of the animal. Obese animals are also at increased risk of complications following anesthesia or surgery.
Obese dogs are more likely to develop urinary incontinence, may have difficulty breathing, and overall have a poorer quality of life compared to non-obese dogs, as well as having a lower life expectancy. Obese cats have an increased risk of diseases affecting the mouth and urinary tract. Obese cats which have difficulty grooming themselves are predisposed to dry, flaky skin and feline acne.
Obesity in Canada is a growing health concern, which is "expected to surpass smoking as the leading cause of preventable morbidity and mortality … and represents a burden of Can$3.96 (US$3.04/€2.75) billion on the Canadian economy each year."
While the negative health outcomes associated with obesity are accepted within the medical community, the health implications of the overweight category are more controversial. The generally accepted view is that being overweight causes similar health problems to obesity, but to a lesser degree. A 2016 review estimated that the risk of death increases by seven percent among overweight people with a BMI of 25 to 27.5 and 20 percent among overweight people with a BMI of 27.5 to 30. The Framingham heart study found that being overweight at age 40 reduced life expectancy by three years. Being overweight also increases the risk of oligospermia and azoospermia in men.
Katherine Flegal et al., however, found that the mortality rate for individuals who are classified as overweight (BMI 25 to 30) may actually be lower than for those with an "ideal" weight (BMI 18.5 to 25).
Being overweight has been identified as a cause of cancer, and is projected to overtake smoking as the primary cause of cancer in developed countries as cases of cancer linked to smoking dwindle.
Psychological well-being is also at risk in the overweight individual due to social discrimination. However, children under the age of eight are normally not affected.
Being overweight has been shown not to increase mortality in older people: in a study of 70 to 75-year old Australians, mortality was lowest for "overweight" individuals (BMI 25 to 30), while a study of Koreans found that, among those initially aged 65 or more, an increase in BMI to above 25 was not associated with increased risk of death.
Many organizations have published reports pertaining to obesity. In 1998, the first US Federal guidelines were published, titled "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report". In 2006 the Canadian Obesity Network published the "Canadian Clinical Practice Guidelines (CPG) on the Management and Prevention of Obesity in Adults and Children". This is a comprehensive evidence-based guideline to address the management and prevention of overweight and obesity in adults and children.
In 2004, the United Kingdom Royal College of Physicians, the Faculty of Public Health and the Royal College of Paediatrics and Child Health released the report "Storing up Problems", which highlighted the growing problem of obesity in the UK. The same year, the House of Commons Health Select Committee published its "most comprehensive inquiry [...] ever undertaken" into the impact of obesity on health and society in the UK and possible approaches to the problem. In 2006, the National Institute for Health and Clinical Excellence (NICE) issued a guideline on the diagnosis and management of obesity, as well as policy implications for non-healthcare organizations such as local councils. A 2007 report produced by Derek Wanless for the King's Fund warned that unless further action was taken, obesity had the capacity to cripple the National Health Service financially.
Comprehensive approaches are being looked at to address the rising rates of obesity. The Obesity Policy Action (OPA) framework divides measure into 'upstream' policies, 'midstream' policies, 'downstream' policies. 'Upstream' policies look at changing society, 'midstream' policies try to alter individuals' behavior to prevent obesity, and 'downstream' policies try to treat currently afflicted people.
There is a common misconception that spot exercise (that is, exercising a specific muscle or location of the body) most effectively burns fat at the desired location, but this is not the case. Spot exercise is beneficial for building specific muscles, but it has little effect, if any, on fat in that area of the body, or on the body's distribution of body fat. The same logic applies to sit-ups and belly fat. Sit-ups, crunches and other abdominal exercises are useful in building the abdominal muscles, but they have little effect, if any, on the adipose tissue located there.
Obesity has been observed throughout human history. Many early depictions of the human form in art and sculpture appear obese. However, it was not until the 20th century that obesity became common — so much so that, in 1997, the World Health Organization (WHO) formally recognized obesity as a global epidemic. Obesity is defined as having a body mass index (BMI) greater than or equal to 30 kg/m, and in June 2013 the American Medical Association classified it as a disease, with much controversy.
In countries of the Organisation for Economic Co-operation and Development (OECD), one child out of five is overweight or obese. Once considered a problem only of high-income countries, obesity rates are rising worldwide. Globally, there are now more people who are obese than who are underweight, a trend observed in every region over the world except parts of sub-Saharan Africa and Asia. In 2013, an estimated 2.1 billion adults were overweight, as compared with 857 million in 1980. Of adults who are overweight, 31% are obese. Increases in obesity have been seen most in urban settings.
Since body fat can be measured in several ways, statistics on the epidemiology of obesity vary between sources. While BMI is the most basic and commonly used indicator of obesity, other measures include waist circumference, waist-to-hip ratio, skinfold thicknesses, and bioelectrical impedance. The rate of obesity increases with age at least up to 50 or 60 years old.
The OECD notes that — given the health, economic, and social consequences of obesity — many countries have built multi-stakeholder networks involving civil society and the business sector in order to devise appropriate public health policies and solutions for obesity prevention.
Several studies have shown that obese men tend to have a lower sperm count, fewer rapidly mobile sperm and fewer progressively motile sperm compared to normal-weight men.
Obesity in Germany has created a cholesterol problem. High cholesterol is known to cause premature death, angina, heart disease and strokes.
There has been an increase of children with Type 1 diabetes between 1996 and 2011. Diabetics are at higher risk for complications such as heart attack and stroke. In Germany, 600,000 people suffered from diabetes near the end of World War II compared to eight million now.
Obesity can increased risk for secondary diseases such as diabetes, cardiovascular disease, certain cancers and Alzheimer's. Children who get diabetes can expect to lose 10 to 15 years off of their lives. Diabetes also affect the eyes, kidneys and nerves in the legs.
Obesity is a "very strong promoter of cancer." Obesity causes an increased risk for colon cancer and breast cancer.
Obesity in Greece is a growing health concern with health officials stating that it is one of the leading causes of preventable deaths in Greece.
The percentage of overweight Ukrainians is at 53% of the population and the percentage of Ukrainians who meet the definition of obese is 20%. Statistics show that Ukrainians continue to gain weight. Doctors claim that the regions with the ""thickest Ukrainians"" are Donetsk and Poltava regions. Crimea is considered ""the most slender region of the country"" The percentage of overweight people in Crimea is 49,7% and the percentage of people who meet the definition of obesity is 12,3%.
Several studies have shown that obese men tend to have a lower sperm count, fewer rapidly mobile sperm and fewer progressively motile sperm compared to normal-weight men.
Until the late 20th century, dietary issues in Mexico were solely a question of undernutrition or malnutrition, generally because of poverty and distribution issues. For this reason, obesity was associated with wealth and health, the latter especially in children. Despite changes in the Mexican diet and food distribution, malnutrition still remains problematic in various parts of the country.
Obesity in Mexico is a relatively recent phenomenon, having been widespread since the 1980s with the introduction of processed food into much of the Mexican food market. Prior to that, dietary issues were limited to under and malnutrition, which is still a problem in various parts of the country. Following trends already ongoing in other parts of the world, Mexicans have been foregoing traditional whole grains and vegetables in favor of a diet with more animal products, more fat, and more sugar much of which is a consequence of processed food. It has seen dietary energy intake and rates of overweight and obese people rise with seven out of ten at least overweight and a third clinically obese.
The Ukrainian Health Ministry stated in late 2012 that ""70% of students do not get enough fruits, vegetables and dairy products."" Eating the wrong food can ""lead to a deficiency of essential nutrients in the body, digestive system and heart, obesity, diabetes and even cancer."" Chief Dietitian Ministry Oleg Shvets said that ""the blame - a habit to eat properly. Excess sweet, refined foods, sodas and juices from concentrate has a daily rate of one third of Ukrainian students.""