Diet and exercise may not treat obesity

Doctors should now concentrate more on the drugs and lifestyle changes that one can opt for to lose weight

To treat people who are obese, doctors need to move beyond simply telling their patients to eat less and exercise more, some researchers argue. Instead, doctors should focus on the biological mechanisms that make it hard for obese people to lose weight, reports

Mind over matter
When people diet, the body thinks that it’s starving, so several biological mechanisms kick in to encourage people to eat more so that they gain the weight back, said Christopher Ochner, an assistant professor of pediatrics and psychiatry at the Icahn School of Medicine at Mount Sinai in New York. The body slows down the rate at which it burns calories in order to conserve fat, Ochner said. These mechanisms originally evolved to help humans survive when food was scarce, but “the problem is that the same mechanisms kick in if somebody is 400 lbs and is trying to lose 40 lbs,” Ochner said. This explains why about 95 per cent of people who lose weight eventually regain it.

Drugs and surgery the answer?
Doctors should be aware that giving advice about diet and exercise is not going to be enough for many, Ochner said. More attention should be paid to biological treatments for obesity, such as drugs and surgery, he added. But current biological treatments for obesity are expensive, and data on the long-term effectiveness of newer drug treatments is lacking, Ochner said. Weight-loss surgery is so far the only treatment for obesity that has been shown to be effective.

Lifestyle change is a part of the answer
Doctors should consider prescribing obesity medication in conjunction with encouraging patients to change their lifestyles. “We recommend the use of lifestyle modification to treat individuals with sustained obesity, but it should be only one component of a multimodal treatment strategy,” Ochner and his colleagues wrote in the February issue of the journal The Lancet Diabetes & Endocrinology.