Medical-Surgical Management

Medical-Surgical Management

Medical-surgical management of overweight and obesity typically involves a combination of lifestyle modifications, pharmacotherapy, and surgical interventions. The goals of management are to reduce the risk of obesity-related complications, improve quality of life, and promote long-term weight loss maintenance.

Lifestyle modifications are considered the first-line approach to management and include dietary changes, increased physical activity, and behavioral interventions. A calorie-restricted diet that emphasizes nutrient-dense foods such as fruits, vegetables, whole grains, lean protein, and healthy fats can help individuals achieve sustainable weight loss. Regular physical activity is also important and can include activities such as brisk walking, cycling, or swimming for at least 150 minutes per week. Behavioral interventions, such as cognitive-behavioral therapy and motivational interviewing, can help individuals overcome barriers to lifestyle change and improve adherence to treatment (National Heart, Lung, and Blood Institute, 2021).

In addition to lifestyle modifications, pharmacotherapy may be considered for individuals with a BMI of 30 or above, or a BMI of 27 or above with obesity-related comorbidities. Medications such as orlistat, liraglutide, and phentermine/topiramate have been approved by the U.S. Food and Drug Administration (FDA) for weight management and can be used in conjunction with lifestyle modifications to promote weight loss (U.S. Food and Drug Administration, 2021). However, pharmacotherapy is not suitable for everyone and should only be used under the supervision of a healthcare provider.

Surgical interventions, such as gastric bypass and sleeve gastrectomy, may be considered for individuals with a BMI of 40 or above, or a BMI of 35 or above with obesity-related comorbidities. These procedures work by reducing the size of the stomach or bypassing a portion of the small intestine, which can help individuals achieve significant weight loss and improve metabolic health outcomes (American Society for Metabolic and Bariatric Surgery, 2021). However, surgical interventions are associated with potential risks and complications and should only be considered after a thorough evaluation by a healthcare provider.

It's important to note that medical-surgical management of overweight and obesity should be individualized and based on a comprehensive assessment of the individual's health status, preferences, and goals. A multidisciplinary team approach that includes a healthcare provider, registered dietitian, physical therapist, and behavioral specialist can help individuals achieve the best possible outcomes.

Reference:

American Society for Metabolic and Bariatric Surgery. (2021). Procedures. Retrieved from https://asmbs.org/patients/bariatric-surgery-procedures

National Heart, Lung, and Blood Institute. (2021). Managing overweight and obesity in adults: Systematic evidence review from the Obesity Expert Panel. Retrieved from https://www.nhlbi.nih.gov/sites/default/files/media/docs/obesity-evidence-review.pdf

U.S. Food and Drug Administration. (2021). Drugs for weight loss. Retrieved from https://www.fda.gov/drugs/resources-information-approved-drugs/drugs-weight-loss