3 medical options for treating obesity

Various treatments exist to help obese people lose weight.

But before these can happen, you must fulfill certain criteria and your doctor will conduct tests to check if the treatment is safe for you. Once you’re medically cleared to proceed, here’s what to expect. 

To qualify for obesity treatment, patients should generally have a BMI of 30 or higher. However, Dr Preetha Thomas, a gastroenterologist at Mediclinic Kloof in Pretoria, says there are exceptions: “In some patients with serious medical conditions such as obstructive sleep apnoea or diabetes, the BMI may not be considered important prior to treatment initiation. The goal for these patients would be weight loss in order to improve their chronic conditions.” 

Bear in mind also that obesity therapies involve multidisciplinary teams, i.e., doctor, dietician, and biokineticist, for the patient to achieve the best possible results. “Patients must also understand that losing weight can be a challenging process,” says Dr Thomas. “We strongly recommend that patients see a psychologist for any underlying mood disorders, eating disorders or motivational issues.” A personalised healthy diet and exercise programme is also designed to complement obesity treatment. This will be discussed and created within the multidisciplinary team.

If you don’t have underlying conditions that exclude further intervention, a few other obesity treatment options are available: 

Medical therapies 

 There are pharmacological therapies on the market that may help in reducing obesity, says Dr Thomas. “Most of the drugs we use work to reduce the appetite, assisting the patient to lose weight while they continue with appropriate lifestyle changes.” Some of the prescribed drugs are not specifically for weight loss, she adds. “However, due to hormonal, enzymatic or receptor regulation effects that they have, weight loss occurs as a result. These drugs are not without their side-effects, just like any other medication, but with appropriate prescribing from a qualified practitioner, they can be used with good effect.” 

Endoscopic procedures 

Endoscopic procedures for treating obesity have become more advanced over the years. Endoscopy entails inserting an instrument with a camera – called a scope – into your stomach. From there, your doctor can facilitate various procedures. 

“One such procedure is the introduction of a balloon into the stomach,” says Dr Thomas. “The balloon takes up space in the stomach, thereby reducing the appetite and facilitating weight loss.” The balloon can remain in the stomach for a period of six to 12 months, depending on the patient’s choice. It does not create any changes in the stomach and at the end of therapy, it’s deflated and removed. 

Another obesity procedure is called the endoscopic sleeve gastrectomy. “This procedure involves placing stitches along the wall of the stomach in order to physically reduce the size of the stomach,” says Dr Thomas. The procedure is irreversible and with appropriate dietary changes, it yields good results, she adds. 

Surgery

For patients who have not experienced success with medical or endoscopic obesity treatments, surgery is an option. Surgery is also considered for patients with a very high BMI. “Bariatric surgeons perform different types of gastric bypass surgeries,” explains Dr Thomas. “Most of these involve removing a portion of the stomach and reattaching it to a portion of the small intestine. These procedures are not reversible and require a change in dietary habits, just as medical and endoscopic therapy do.” 

Different therapies work within different timelines, and this also depends on the patient’s lifestyle and body. “In general, medical therapy alone results in ±10-15% of weight reduction per year, endoscopic therapy 20-35% per year, while surgery can result in 55-65% reduction,” says Dr Thomas. Generally, a healthy lifestyle helps the patient achieve optimal results from these medical interventions – and this is always the key to combatting obesity in the long run.