Weight Loss Therapy Options.

Lifestyle & behavioural modifications:
• Lifestyle interventions are recommended for all
overweight patients.
  They should be continued
even if medication or surgery options are used.
E.g. ŠConsider membership at a suitable gym
e.g. Curves
ŠLimit computer & TV “screen-time” for kids
Drug therapy:
• The role of weight loss drugs is of some debate.
Limited long-term effectiveness and risks must be
weighed against the complications associated with
obesity such as diabetes and heart disease.  
• A 6 month trial of diet, exercise & behavioural
therapy is recommended prior to considering drug
therapy.
  Drug therapy may be considered in
select patients: obese patients (BMI ≥30kg/m) or
those with a BMI ≥27 kg/m + 1 risk factor
(diabetes, hypertension, hyperlipidemia, coronary
artery disease or sleep apnea).  Safety, efficacy
and overall costs should be considered.
Surgery (e.g. Roux-en-Y gastric bypass or duodenal switch):
• Surgery may be considered in select patients
{obesity class III (BMI≥40 kg/m) or obesity class II (BMI 35-
39.9 kg/m) + ≥1 severe obesity related medical complications}.
• Mortality rates (generally between 0.1%-1.1%) vary
with surgery type and experience of centre.