IPHREHAB : OBESITY & TREATMENT

IPHREHAB

OBESITY & TREATMENT

TREATMENT
Behavior Modification is most important in programs of weight reduction. 
Typically, the patient is requested to monitor and record the circumstances related to eating, and rewards are designed to modify maladaptive behaviors. 
Patients may benefit from counseling offered in a stable group setting.

DIET THERAPY
Diet  forms most important treatment in Obesity
Reduced caloric intake is cornerstone. 
Sustained reduction of energy intake rather very is difficult. 
Eating 100 kcal/d less for a year should cause a 5-kg weight loss, and a deficit of 1000 kcal/d should cause a loss 1 kg per week.

Very low energy diets (e.g., 400 to 600 kcal/d) are widely used. The liquid protein diets popularized in the 1970s were proved to be unsafe

No obesity is seen during femine

No obese is centenarian 

EXERCISE

Exercise is another important component

Exercise leads  to Increased energy expenditure 

It should be gradual and under medical supervision 

Exercise appears to be a valuable means to sustain diet therapy 

Valuable in the obese individual for its effects on cardiovascular tone and blood pressure. 

DRUG THERAPY

Drug treatment of obesity is not very  efficacious. 

Phentermine  & phenylpropanolamine :-an amphetamine-like drug with low addictive potential has shown modest efficacy.

Fenfluramine, have modest efficacy.. But there is the risk of pulmonary hypertension.

SIBUTRAMINE

Sibutramine is a novel latest Drug.

It is of inhibitor norepinephrine, serotonin and Intestinal lipase.

Using a once-daily dose over 24 weeks, it produced a 7% weight loss. 

It lowered cholesterol and triglyceride.

Sibutramine increases pulse and blood pressure in some patients.

CONCLUSIONS

Obesity is becoming an epidemic.

USA is the most obese country-25%

Japan & France are slim countries.

There is rise in childhood obesity.

Diet & Exercise are the best methods to reduce weight.

Drugs have limited role.