Management of Weight and Obesity
Management of obesity is its treatment. Because of its numerous causes and contributions from a complex assortment of factors, treatment must be individualized for the patient. For example, depression requires including its treatment as part of weight management. The psychological aspects of obesity can include unipolar and bipolar disorders and personality disorders all the way to psychosis.
Any drugs that have weight gain as a side effect should be replaced with another equally effective drug for its indication. Since any drug can do anything to anybody, it is often necessary to make adjustments based on trial and error. This emphasizes that weight management is a long-term process.
In women, hormonal shifts can add more weight than just fluid retention. Some hormonal birth control methods (e.g., DepoProvera injections) can result in monthly weight gain. Also, the insulin-resistance condition of Polycystic Ovarian Syndrome (PCOS) causes weight gain as well as virilizing signs due to elevations in a woman’s testosterone.
Comorbidities such as cardiovascular disease, diabetes, and the metabolic syndrome require management as well.
All overweight persons should be counseled about diet, physical exercise, alterations of lifestyle and behavior, and reasonable goals for weight loss.
The mind-body connection is not well understood, but how it benefits from exercise has been well established. Besides just burning calories, helpful in any calorie-restriction diet, it also benefits mental health to defuse any psychological influences on behavior that may interfere with attaining one’s goals.
Psychological aspects that lead to obesity should be addressed via a social worker, psychologist, or psychiatrist, depending on the severity of the mental illness. Care must bet taken when antidepressants are prescribed as some may cause weight gain.
The linchpin to management is the diet. It should be designed by a professional dietitian/nutritionist and personalized for the patient to take into account non-dietary influences on the diet. Of crucial importance is that the diet should not be drastic or unreasonable. Anything less is doomed as a recipe for failure, which will only keep the patient in the vicious cycle of repeated unsuccessful attempts to lose weight.
Overweight and obese patients face a problem that is bigger than themselves and require a dedicated multi-prong approach from many providers to meet their goals. Once weight management is needed, it is then a lifelong commitment to good physical and mental health.