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How Is Obesity Treated?

Reviewed by Brunilda Nazario, MD on September 21, 2022
instructor at diet club

If you’re obese, a variety of treatments can help you lose weight. Doing so lowers your chances of getting diabetes, heart disease, stroke, high blood pressure, and other diseases and conditions.

Losing weight looks different for everyone. Some people chose a treatment for obesity focused on nutrition, exercise, or both. There are also medications, procedures, and other therapies that have helped others shed pounds.

What Is Obesity?

The CDC defines obesity as having a body mass index of 30 or higher. Losing weight can lower your BMI and put you closer to – or in – what’s considered a healthy weight range.

How Can I Tell if I Am Obese?

Before you explore obesity treatments, it’s a good idea to know if you’re clinically obese. Your doctor or other health care professional may do that by:

Doing a physical exam. Stepping on the scale gives you a current weight. The doctor or health care professional will likely check your temperature, heart rate, and blood pressure; listen to your heart and lungs; and look at your belly.

Checking for other problems. They may do lab tests for high blood pressure, high cholesterol, underactive thyroid, liver problems, or diabetes. This can help you better understand your overall health and customize an obesity treatment.

Recording your health history. The health care professional may ask about your weight history, any past weight loss efforts, how and how often you’re active, and what your eating patterns are like. They’ll want to know about existing diseases and conditions, medications you may take, your general health, and the health of your family members, including parents and grandparents.

Measuring yourwaist. You may have a higher risk for certain health conditions based on the distance around your waist, or its circumference. Fat in this area (known as visceral fat or abdominal fat) can raise your risk for certain diseases and conditions. (Women whose waists are over 35 inches and men whose are over 40 may have a greater chance of heart disease and type 2 diabetes).

Determining your BMI. The CDC classifies obesity based on BMI, a measure of body fat based on your weight and height. A lot of research that links weight and health benefits uses BMI instead of weight alone.

  • If your BMI is less than 18.5, you’re in the underweight range.
  • If your BMI is 18.5 to 24.9, you’re in the healthy weight range.
  • If your BMI is 25 to 29.9, you’re in the overweight range.
  • If your BMI is 30 or higher, you’re in the obesity range.

There are three categories of obesity:

  • Class 1 is a BMI of 30 to 34.9.
  • Class 2 is a BMI of 35 to 39.9.
  • Class 3 is a BMI of 40 or higher and is sometimes called severe obesity.

Being aware of which obesity class you may be in can help to guide your obesity treatment options.

What Obesity Treatments Are Available?

Diet. Making sure you are getting the proper nutrition is vital to keep your body running well. It can also help you lose weight. You don’t have to go on a formal diet to lose weight. There are many diet programs that support weight loss, or you can make small changes to improve what you now eat.

In general, cut down on how many calories you eat to lose weight. Talk to your doctor to see how many calories you should be taking in each day, based on which obesity treatment you use. Ask how to make sure your body also gets the nutrients it needs to function at its best. For example, if you have weight loss surgery, you will probably eat differently than if you are trying to lose weight with diet alone.

Exercise. Being active can help your body lose weight by burning calories. Many people use diet and exercise to lose weight. Working out – even if it’s not a hard or long workout – offers general health benefits, too. Likewise, being less sedentary is linked to improved health outcomes.

Behavior changes. Support groups and individual counseling can help some people lose weight. You may change behaviors linked to the way you eat and move, or identify ways to overcome other obstacles to weight loss.

Surgery. A few types of surgeries, such as gastric sleeve and gastric bypass, can help people with obesity to lose weight. Many doctors will consider surgery only if you have not been able to lose weight using other obesity treatments, or if you have a high risk for getting other weight-related health problems. If you have weight loss surgery, you'll still need to change your diet and exercise for lasting results.

Endoscopic procedures. Endoscopic sleeve gastroplasty and intragastric balloon insertion are used without having to cut into the skin. If you choose one of these, you will be under anesthesia when a flexible tubes and tools are inserted through the mouth and down to the stomach.

Medications. There are a lot of prescription and nonprescription medications on the market that may help you lose weight. But doctors may only prescribe them if you have a BMI over 30 (or if it is at least 27 and you have a weight-related issue like high blood pressure or diabetes). Studies show that people who combine healthy eating and exercise with these drugs can have better results than just taking the medication alone.

The FDA has approved these drugs for weight loss:

  • Orlistat (Xenical) (A lower dose, known as Alli, is available over the counter.)
  • Phentermine-topiramate (Qsymia)
  • Naltrexone-bupropion (Contrave)
  • Liraglutide (Saxenda)
  • Semaglutide (Wegovy)
  • Setmelanotide (IMCIVREE)

Are Off-Label Drugs a Good Obesity Treatment?

A few drugs are FDA-approved to treat other diseases, but they’ve helped people with those ailments lose weight. Your doctor may prescribe one of these drugs, even if you don’t have the disease that the drug is approved to treat. These are called off-label uses. Your doctor may combine drugs for weight loss or may have you stay on a medication longer than the directions say.

Some of the medications prescribed for weight loss on an off-label basis are:

  • Metformin: Studies have found that people without diabetes who took this diabetes medication had a lower BMI. But the amount of weight lost was relatively low: One study found that the mean (average) percentage of weight that people were able to lose and keep off, compared to their starting weight, was around 6%.
  • Tirzepatide: This drug is approved for the treatment of diabetes. In a trial, 85% of people who took 15 milligrams of this drug weekly lost 5% or more of their body weight, and more than half lost up to 20%. The average amount lost was 22.5%. Researchers also found that side effects included nausea, vomiting, and diarrhea. But these were relatively mild and happened mostly as people were adjusting to a bigger dose.
  • Topiramate: Several studies and clinical trials have found this anticonvulsant drug to be effective for weight loss. One trial found that a study group lost up to 9.7% of their body weight in less than a year. But topiramate comes with side effects that include memory and language problems and depression.

What Is the Best Treatment for Obesity?

There is no one treatment for obesity that is “best.” Finding something that works for you can depend on lot of things, including your lifestyle and general level of health.

Talk to your doctor or other health care professional to come up with an obesity treatment that may work for you. They can advise you on which treatments these may be, based on your health status, and let you know about any new or upcoming treatments for obesity.

Show Sources

SOURCES:

American Academy of Family Physicians.

Diabetology & Metabolic Syndrome: “The Best Drug Supplement for Obesity Treatment: A Systematic Review and Network Meta-Analysis.”

Dove Press: “Off-Label Drugs for Weight Management.”

Journal of Obesity & Metabolic Syndrome: “Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance.”

Mayo Clinic: “Obesity.”

National Heart, Lung, and Blood Institute: “Assessing Your Weight and Health Risk,” “Classification of Overweight and Obesity by BMI, Waist Circumference, and Associated Disease Risks.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Prescription Medications to Treat Overweight & Obesity,” “Types of Weight-loss Surgery,” “Health Risks of Overweight & Obesity.”

National Health Service (U.K.): “Why We Should Sit Less.”

Annals of Internal Medicine: “Long-Term Weight Loss With Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study.”

The New England Journal of Medicine: “Tirzepatide Once Weekly for the Treatment of Obesity.”

International Journal of Obesity and Related Metabolic Disorders: “A randomized double-blind placebo-controlled study of the long-term efficacy and safety of topiramate in the treatment of obese subjects.”

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