Barriers to the treatment of obesity

Article Abstract:

There are effective appetite suppressant drugs that are available to treat obesity. Older drugs such as the amphetamines, have a well-recognized potential for abuse, and their use in the treatment of obesity is no longer approved. However, drugs such as phentermine, diethylpropion, mazindol, and fenfluramine are relatively safe and effective, with little potential for abuse. However, these drugs are not widely used in treating obesity. One problem is the public perception of obesity as a problem of weak will, rather than as a disease. Surveys have shown that this attitude is also common among health care workers. A related attitude problem involves the perception of the effectiveness of the drugs themselves. When drug treatment is terminated, patients almost invariably gain back some weight; this has been regarded as a sign that these drugs are ineffective. This is a curious attitude on the part of health care professionals. High blood pressure (hypertension) returns if high blood pressure drugs are discontinued; peptic ulcers return if the H2-blocker medication is discontinued; and serum cholesterol rises if cholesterol-lowering medication is discontinued. In all these cases, there is no expectation that the underlying condition can be 'cured', but only that it can be treated. Since the drugs are not expected to cure the condition, there is no perception of ineffectiveness when their discontinuation brings a return of the signs and symptoms. Why drugs should be expected to cure obesity is not clear. Nevertheless, few physicians prescribe these drugs for long periods of time, despite the evidence that the drugs are safe. Little research is available on which to base decisions about treating obese patients. One major center devoted to the study of obesity exists in the US, and only $35 million is spent each year on obesity. For purposes of comparison, $800 million is spent each year on AIDS research. The cost of caring for AIDS patients is about $4.3 billion each year, but Americans spend $35 billion each year on the never-ending quest for weight loss. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Appetite depressants, editorial

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Reduction in Obesity and Related Comorbid Conditions after Diet-Induced Weight Loss or Exercise-Induced Weight Loss in Men

Article Abstract:

Exercise can decrease body fat even if no weight is lost. This was the conclusion of a study of 52 obese men who were randomly assigned to one of four groups: diet-induced weight loss, exercise-induced weight loss, exercise without weight loss, and no lifestyle changes. Men who exercised improved their cardiovascular fitness and lost fat tissue. Men who dieted lost fat tissue also, but not as much as those who exercised. Men who exercised and lost weight were less likely to have insulin resistance, which is a precursor of type 2 diabetes.

Health aspects, Reducing diets, Exercise, Weight loss

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Screening for obesity in adults: recommendations from the U.S. Preventive Services Task Force

Article Abstract:

People who are obese may benefit from intensive counseling sessions at least twice a month that include advice on dietary and other lifestyle changes as well as behavioral therapy. Diet pills may be effective but they also have side effects. Surgery can be effective but it also has complications.

Reports, United States. Preventive Services Task Force

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