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Feature Article

Management of obesity

Sharon Marks

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Abstract

Levels of overweight and obesity in Australia, as well as overseas, are escalating. The treatment of obesity should be divided into an initial weight-loss phase followed by long-term maintenance. Barriers to good management strategies are many because medical issues such as diabetes, hyperlipidaemia and hypertension often take precedence.

Key Points

  • Weight loss will occur if an energy deficit is sustained. There are many ways to achieve this and so individual counselling as well as trial and error is necessary.
  • Weight management should be divided into the initial weight-loss phase followed by long-term weight maintenance. Strategies for both phases need to be developed with acknowledgement of the very easy weight regain seen in patients who are unable to maintain an energy deficit.
  • Expected weight gain after changes in medication or lifestyle can sometimes be avoided if both the patient and doctor are proactive rather than reactive.
  • Treatments currently available, either licensed or used off-label, are not usually sufficient to achieve and maintain the ideal bodyweight and so goals such as risk-factor modification and reduction in medications that cause weight gain become more important.

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