• Vol. 38 No. 1, 22–28
  • 15 January 2009

Medical Management of Obesity and its Complications



Obesity is increasing and with this comes an increase in Metabolic Disease. Current therapies are effective. We need to establish groups that are experts in “lifestyle therapy” but make sure that they use the very effective adjunctive therapies when indicated. Whilst bariatric surgery is effective for those with Grade III obesity, it is important to realise that medical therapy is very effective for those who are overweight or with lesser degrees of adiposity. There needs to be a proper lifestyle programme and the use of adjunctive treatment when necessary. This approach can reduce weight, reduce cardiovascular risk, help control diabetes and prevent it. We MUST establish proper treatment programmes and follow-up systems.

Overweight and obesity are common in many countries throughout the world, and their prevalence is increasing not just in developed countries but also in developing countries as they become more affluent. While there is some discussion about whether obesity prevalence is increasing at as fast a rate, the fact remains that prevalence is high and increasing. With increasing obesity prevalence comes increasing obesity-associated disease. This is basically of 2 types; metabolic [type 2 diabetes mellitus (T2DM), hypertension, dyslipidaemia and consequent heart disease] and mechanical (obstructive sleep apnoea, osteoarthritis). Both major groupings of disease are improved by weight loss and proper management of weight and therefore it is necessary to understand modern management.

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