If you’ve developed obesity, a variety of treatment options 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 excess weight looks different for everyone. Some people chose a treatment that focuses on nutrition, exercise, or both. There are also options like medications, procedures, and other therapies that have helped others shed pounds.
What Is Obesity?
Obesity is considered a chronic and progressive medical condition. 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 Have Obesity?
Before you explore obesity treatments, it’s a good idea to know if your body weight is above normal. 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 do a physical exam and measure your waist
Checking for other problems. They may do lab tests checking for an 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 regularly you exercise, and what your eating patterns and support systems are like. They’ll want to know about existing diseases and conditions, medications you may take that may hinder weight loss, your general health, and the health of your family members, including your parents and grandparents.
Measuring your waist. You may have a higher risk for certain health conditions based on your waist size or its circumference. Fat in organs 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 have a greater chance of heart disease and type 2 diabetes).
Determining your BMI. The CDC classifies obesity based on BMI, an estimated 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, others use body composition as a more accurate measure of body fat and lean body mass.
- If your BMI is less than 18.5, your weight is in the underweight range.
- If your BMI is 18.5 to 24.9, your weight is in the healthy weight range.
- If your BMI is 25 to 29.9, your weight is in the overweight range.
- If your BMI is 30 or higher, your weight is in the obesity range.
BMI is interpreted differently in children and teens, even though the same formula is used. This is because the amount of body fat changes with age and is different in boys and girls.
For adults, there are three categories that define 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 your BMI can help guide your obesity treatment options. Because of known health risks associated with excess body weight, anyone with BMI >25 is a candidate for weight-loss and weight maintenance interventions.
What Treatments Are Available?
Diet and lifestyle interventions are key to losing and managing weight long term. However, there are also options such as drugs, devices, and surgeries available to treat obesity.
Medications. There are a lot of prescription and nonprescription medications on the market for weight loss. But doctors may only prescribe medications 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:
- Benzphetamine (Didrex)
- Diethylpropion (Tenuate)
- Liraglutide (Saxenda)
- Naltrexone-bupropion (Contrave)
- Orlistat (Xenical) (A lower dose, known as Alli, is available over the counter.)
- Phendimetrazine (Bontril PDM, Obezine, Phendiet, Plegine, Prelu-2)
- Phentermine( Adipex-P, Lomaira)
- Phentermine-topiramate (Qsymia)
- Semaglutide (Wegovy)
- Setmelanotide (IMCIVREE)
Diet. Making sure you are getting the proper nutrition is vital to keep your body running well. It helps you with weight loss. 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 your 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 excess fat weight by burning calories and helps prevent muscle loss while dieting. Many people use diet and exercise to lose weight. Working out offers general health benefits, too. Likewise, being less sedentary is linked to improved health outcomes. Regular exercise helps keep the weight off.
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. Several types of surgeries, such as gastric sleeve and gastric bypass, can help people who have 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 of getting other weight-related health problems. These procedures increase a sense of fullness.
Devices. Intragastric balloon devices are approved for use for up to 6 months. They are inserted and removed through an endoscope. If you choose one of these, you will be under anesthesia. These devices decrease calorie intake by increasing a sense of fullness. Plenity is the brand name of a prescription capsule for weight loss that is considered a medical device. The capsules contain a hydrogel that is taken with water before eating They expand in your stomach and make you feel full, then come out as waste. It’s a good option for people who aren’t eligible for surgical treatments.
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. 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 but it is effective in the treatment of obesity in patients with and without diabetes mellitus. It is a GLP-1 and GIP receptor agonist administered once weekly by injection. In a trial, 85% of people who took 5 milligrams of this drug weekly lost 5% or more of their body weight, and more than half lost up to 20%.
- 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 a lot of things, including your lifestyle and general level of health.
Talk to your doctor or other health care professional to come up with a treatment plan that works 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.