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Updates in Obesity Part 3 of 3 – How to take control

We know now that after losing weight hunger level increases.

Any exercise helps.  Exercise is so much more than simply burning calories – it also reduces inflammation that is involved in trajectory of positive obesity management. An added benefit is that muscle loss is also prevented.  The current recommendation is to be involved in some form of exercise for at least 150 minutes a week (about 20-25 minutes a day).

It has been known for a while that poor sleep patterns also increase inflammation within the body, which is an important factor in patients developing obesity and complications as a result.

Bariatric surgery not only helps to reduce the volume of food we are eating in a single setting, it also makes important changes to enzymes, mediators, nutrients, mucus and bile acids.  It also has been discovered that bariatric surgery has positive effects with microbiomes for the Gastro-Intestinal Tract (neuronal, hormonal, immune changes and CNS systemic effects).

Some of the more obvious changes is that it has been shown in some cases to reverse diabetes, hypertension, obstructive sleep apnoea. The mortality and morbidities with this type of surgery has dramatically improved over the last decade.

When assessing patient with obesity we are taking into account –

  • genetics
  • work schedule
  • sleep pattern
  • stress and stressors
  • previous attempts to lose weight
  • socio-economic position
  • exercise pattern
  • medications

 

Drugs that have been associated with weight gain include – Gabapentin, Pregabalin, Suboxone, and Mirena.

Drugs such as Phentermine, Liraglutide, Topiramate, Naloxone, and Bupropion can be used in weight loss programs – either alone or in combination with other modalities.

We know from different studies that if you are on a diet and medications that feeling constantly hungry can be a good predictive factor in predicting good outcome – which in this case is significant weight loss.

Key interventions that work/help regardless of the method of weight loss used –

  • caloric deficit
  • sleep improvement
  • Incorporating a Mediterranean diet
  • eating non-processed food
  • exercising 150 minutes a week (or building up to this amount)
  • resistance training
  • behavioural therapy

At CBD Doctors Melbourne we assess every patient’s condition individually and will be happy to support you throughout your journey – regardless of if it is diet, exercise, medications, surgery or counselling and referral to our dietitian and psychologists.

Obesity is a chronic disease, which requires ongoing treatment, multiple interventions, monitoring and a long-term maintenance program.

We are happy to explore these options with you.

 

Dr Jelena Radosavljevic

Practice Principal, CBD Doctors Melbourne

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