Management of obesity

Management of obesity can include lifestyle changes, medications, or surgery. Although many studies have sought effective interventions, there is currently no evidence-based, well-defined, and efficient intervention to prevent obesity. The main treatment for obesity consists of weight loss via healthy nutrition and increasing physical exercise. A 2007 review concluded that certain subgroups, such as those with type 2 diabetes and women who undergo weight loss, show long-term benefits in all-cause mortality, while long‐term outcomes for men are "not clear and need further investigation." The most effective treatment for obesity is bariatric surgery. Surgery for severe obesity is associated with long-term weight loss 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. Another study also found reduced mortality in those who underwent bariatric surgery for severe obesity. In June 2021, the US Food and Drug Administration (FDA) approved semaglutide injection sold under the brand name Wegovy for long-term weight management in adults. It is associated with a loss of 6-12% body weight along with mild gastrointestinal side effects. Another medication, orlistat, is widely available and approved for long-term use. Its use produces modest weight loss, with an average of at 1 to 4 years, but there is little information on how these medications affect longer-term complications of obesity. Its use is associated with high rates of gastrointestinal side effects. Diet programs can produce short-term weight loss and, to a lesser extent, over the long-term. Greater weight loss results, including amongst underserved populations, are achieved when proper nutrition is regularly combined with physical exercise and counseling. Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve outcomes for both the mother and the child.