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Generalities
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Regulation of the appetite
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Frequency, cost and social consequences of obesity
Major options in the treatment of obesity
Therapeutic strategy for an obese patient
The benefits of surgery in morbidly obese patients
The connexion between overweight and mortality
Evidence in bariatric surgery (part 1)
Evidence in bariatric surgery (part 2)
Generalities

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Generalities

Major options in the treatment of obesity

When we talk about the treatment of obesity, it is important to specify what criteria are used to evaluate the effectiveness of a given treatment. Short-term effectiveness should be discarded right out. We should only be looking at long-term effectiveness. This is where many debates between specialists arise. The methods available to treat obesity can be roughly be divided into three categories, from the simplest to the most intricate (or aggressive) treatment:

- diets and support groups
- drug therapy
- surgical techniques.

>> Diets and support groups:
These are the traditional methods used to treat obesity. There is an overall scientific consensus on their effectiveness. Although they should be the first option to be offered to an obese patient, there comes a point where they are no more an option for those who have repeatedly attempted, but failed weight-loss using such methods. All diets are based on some form of understanding of weightloss, however, the well-founding of some of the diets on offer is sometimes quite dubious. Many are only effective if applied within a given environment or with specific support. The latter offer a good psychological frame but tend to be effective only as long as the patient feels under the constraint of a specific environment, as it is the case with health institutions.

>> Drug therapy:
It is important to distinguish between two types of medical treatment :

- The first deals with the complications linked to obesity such as diabetes, hypercholesteromia, gout.
- The second includes the actual anti-obesity drugs. Some have been tried and abandonned, other more recent drugs are still in the experimental stage.

>> Surgical techniques:
These techniques include actual surgery performed on the upper gastro-intestinal tract (stomach, and sometimes the intestines), although this approach is limited to people with a BMI above 40 kg/m2. Another alternative, the intra-gastric balloon, has not yet been validated.


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