Principles of obesity treatment

Obesity is a chronic disease characterized by an increase (hypertrophy and hyperplasia) adipose tissue due to a positive energy balance.

Therapy



 * 1) Dietotherapy proteins : fats : sugars = 15 : 30 : 55, reducing the amount of fatty foods, increasing the intake of  fiber, broken down to 4 -5 meals a day.
 * 2) Physical activity is recommended 30-40 minutes, 3-4 weeks per week, the patient does not have to lose weight to the ideal weight according to BMI, 10% of the original weight is enough and the risk of cardiovascular disease is significantly reduced.
 * 3) Behavioral psychotherapy
 * 4) Pharmacotherapy:
 * 5) anorexics (reduce appetite) - catecholamine (Adipex), serotonergic, combined (sibutramine) is no longer on sale;
 * 6) thermogenic drugs (increase energy expenditure) - Elsinor powders;
 * 7) substances that affect the absorption of fats in the gut (lipase inhibition) - Orlistat, patients must beware of  diarrhea after a meal containing more fats;
 * 8) surgical therapy - bariatric surgery is performed in patients with the most severe form of obesity, sometimes immobile; We can divide them into restrictive (reducing stomach volume) and malabsorption (reducing the area for nutrient absorption).
 * 9) gastric bandage (laparoscopic adjustable gastric bandage, LABG - laparoscopic, without opening the GIT, a silicone ring tightens the stomach at the top, creating a second pylorus and reducing the stomach volume, the feeling of satiety occurs much earlier);
 * 10) gastric tubulation (sleeve gastrectomy);
 * 11) gastric bypass (the procedure leads to partial  malabsorption, a piece of intestine is bypassed and less nutrients are absorbed from the food);
 * 12) biliopancreatic diversion (shrinkage of the stomach and formation of a bypass between the stomach and the distal half of the ileum);
 * 13) gastric balloon (endoscopic insertion, this method is rarely used today).

In 2009, about 800 bariatric procedures were performed in the Czech Republic. In 2010 already over 1000. Surgical treatment of obesity is, today, the treatment with the highest percentage of success. Pharmacotherapy is less effective.

Related Articles

 * Obesity

Used literature

 * PASTOR, Jan. Langenbeck's medical web page [online]. [cit. 2010]. .


 * ČEŠKA, Richard, et al. Interna. 1. vydání. Praha : Triton, 2010. 855 s. ISBN 978-80-7387-423-0.