Treatment of obesity

Decreases in resting metabolic rate and thermic effect of exercise during and after caloric restriction contribute to a reduced rate of weight reduction and subsequent difficulty in weight maintenance. Increasing exercise increases the thermic effect of exercise and prevents a decrease in resting metabolic rate, thereby, improving the rate of weight loss. A combined program of caloric restriction, exercise, and behavior therapy (including relapse prevention training and social support systems) is the most successful approach to long term weight reduction efforts. Pharmacologic treatment is currently limited, but there are three areas of development: agents which reduce energy intake, inhibitors of lipid synthesis, and thermogenesis enhancers. Evidence for improving efficiency of weight loss prevention and prevention of weight regain during repeated cycles of dieting (yo-yo phenomenon) exists in rat studies but not in a preliminary human investigation.