Medical management of obesity

The prevalence of obesity and obesity-related disorders, such as insulin resistance and hyperinsulinaemia, which form the basis for the Metabolic Syndrome, is still increasing and reaching epidemic proportions. Excess weight, particularly abdominal obesity, elevates multiple cardiovascular and metabolic risk factors, including Type 2 diabetes, hypertension, dyslipidaemia and cardiovascular disease. Therefore, appropriate management of obesity and prevention of obesity-related diseases with high mortality and morbidity is of great importance for public health. Obesity management goals should encompass health improvement and cardiometabolic risk reduction as well as weight loss. Results of treatment of obesity with nonsurgical interventions have been disappointing to date. However, recent data from large-scale studies indicate that only a moderate weight loss is sufficient to provide substantial health benefits. While lifestyle and diet modification form the basis of all effective strategies for weight reduction, some individuals may need additional intervention. This review focuses on the non-surgical treatment for obesity in particular lifestyle modifications and on appropriate use of pharmacotherapy for obesity and cardiometabolic risk.