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Treatment Options

Treating obesity is similar to treating other chronic illnesses, according to Scott Kahan, MD, Director, National Center for Weight and Wellness, George Washington University, Washington, DC. He indicates that BMI, comorbidities, and patient preferences are important to the treatment plan.

Since obesity exists in world populations and all workplace environments, there are no quick fixes or universal options. Bariatric surgery is a tool to reduce food intake, but it needs to be part of a lifestyle change with cultural modifications in the work place and home.

Obesity defines a family and affects every member of the family while impacting the workplace and society. Excess body weight causes increased medical issues, depression, anxiety, decreased morale, and loss of productivity. Employers need to do more to reduce obesity by recognizing what employees eat and drink and encouraging a healthy lifestyle to offset the dangers of vending machines, microwave ovens, and food delivery options that contribute to obesity.

The increase in obesity is a difficult problem facing society today with little success from traditional methods of dieting and exercise. Bariatric surgery offers short-term success, but long-term benefits have yet to be tallied in personal health, medical costs, and quality of life. A meta-analysis of 11 studies reported that bariatric surgical patients lost more body weight and had higher remission rates for type 2 diabetes mellitus (T2DM) compared with nonsurgically managed patients [24].

Personalized treatment plans need to consider the following factors [25]:

Genetic factors like Prader-Willi syndrome, leptin pathway dysfunction, melanocortin 4 receptor gene

Epigenetics imprinting—DNA methylation and histone modifications, maternal obesity, excessive pregnancy weight gain

Environmental factors—high-calorie foods, sedentary behaviors, gut microbiota, stress, sleep patterns, medications

Hypothalmus regulation of energy—hunger, satiety, and energy compensation factors in metabolism

The World Health Organization (WHO) has recognized obesity as a disease and surgery as an option in weight management. Many patients are treated with lifestyle advice and appetite-suppressing drugs but the reality is that those with a BMI >40 are not likely to be successful without surgical treatment.

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