Treatment of obesity

Treatment of obesity

Obesity – Endocrinologist’s Guide on Causes, Diagnosis, and Treatment

Obesity is the excessive accumulation of fat in subcutaneous and other tissues due to metabolic disturbances, resulting in an increase in body weight. This condition can lead to serious health complications if not addressed properly.

Symptoms of Obesity

The main signs of obesity include excessive body weight and associated discomfort. Body Mass Index (BMI) is used to assess body weight. It is calculated by dividing weight (kg) by height squared (m²). BMI classifications:

  • Normal weight: BMI 18.5–25
  • Overweight: BMI 25–30
  • Obesity: BMI ≥30

Forms of Obesity

Obesity can be categorized into alimentary-constitutional, hypothalamic, and endocrine obesity.

  • Alimentary-constitutional obesity: Develops due to excessive calorie intake and low physical activity; may have a partial hereditary basis.
  • Hypothalamic obesity: Caused by dysfunction of the hypothalamic system.
  • Endocrine obesity: Results from endocrine gland disorders such as hypothyroidism, hypercortisolism, or hypogonadism.

Excess calorie intake without sufficient physical activity leads to fat storage. Risk factors include sedentary lifestyle, certain medications (hormonal or antidepressants), genetic predisposition, and physiological states (pregnancy, lactation, menopause). Obesity may also be associated with syndromes like Cushing’s syndrome or Prader-Willi syndrome.

Diagnosis of Obesity

Diagnosis is based on BMI assessment and physical examination. Severity classification:

  • Class I obesity: BMI 30–35
  • Class II obesity: BMI 35–40
  • Class III obesity: BMI 40–50
  • Class IV obesity: BMI >50

Additional tests such as dexamethasone suppression test or radiologic imaging of the head and spine may be performed to differentiate obesity types. Blood glucose monitoring and glucose tolerance tests are recommended, especially if patients report excessive thirst or dry mouth.

Treatment of Obesity

The primary goal of obesity treatment is weight reduction. Approaches include:

  • Diet therapy – balanced, low-calorie diet
  • Physical activity – regular exercise to burn calories
  • Psychotherapy – behavior modification and appetite control
  • Medications to reduce appetite if needed
  • Surgical interventions for severe obesity (Class IV), such as gastric balloon placement, gastric banding, or less commonly, gastric bypass

In secondary endocrine obesity, treatment focuses on the underlying hormonal disorder.

Complications of Obesity

Obesity increases the risk of hypertension, type 2 diabetes, metabolic syndrome, erectile dysfunction, infertility, fatty liver disease, and other serious conditions.

Prevention of Obesity

Prevention is particularly important in individuals with a hereditary-constitutional predisposition. Key strategies include maintaining a balanced diet, reducing calorie intake, and increasing physical activity.

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