Efficacy of Non-Surgical Weight Loss Options

Published scientific reports document that non-operative methods alone have not been effective in achieving a medically significant long term weight loss in severely obese adults. It has been shown that the majority of patients regain all the weight lost over the next five years. The average medical weight reduction trial is a 10-12 week study with average weight loss of 2.5 kg. The use of anorectic medications has recently been advocated as a long term therapeutic modality in management of what is clearly a chronic disease. In a nearly four year study, utilizing a two drug regimen of Phentermine and Fenfluramine, behavior modification, diet and exercise, the initial optimistic results have not been sustained, with a one third drop out rate and a final average weight loss of only three pounds in those who were followed for the four years of the study. This drug combination appears to have an unacceptably high association with cardiac valvular disease and has been withdrawn from therapeutic use because of these potentially life threatening sequelae.

Dietary weight loss attempts often cause depression, anxiety, irritability, weakness and preoccupation with food. The treatment goal for morbid obesity should be an improvement in health achieved by a durable weight loss that reduces life threatening risk factors and improves performance of activities of daily living. Temporary fluctuations of body weight from calorie restricted diets should be avoided.


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