Management of obesity
[2][3][4][5] A 2007 review concluded that certain subgroups, such as those with type 2 diabetes and women who undergo weight loss, show long-term benefits in all-cause mortality, while long‐term outcomes for men are "not clear and need further investigation.
[9] In June 2021, the US Food and Drug Administration (FDA) approved semaglutide injection sold under the brand name Wegovy for long-term weight management in adults.
Its use produces modest weight loss, with an average of 2.9 kg (6.4 lb) at 1 to 4 years, but there is little information on how these medications affect longer-term complications of obesity.
Greater weight loss results, including amongst underserved populations, are achieved when proper nutrition is regularly combined with physical exercise and counseling.
[4][12][14][15][16] Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve outcomes for both the mother and the child.
[24] Dieting for calorie restriction is advised for overweight individuals by the Dietary Guidelines for Americans and United Kingdom's NICE.
Due to the large size of leg muscles, walking, running and cycling are the most effective means of exercise to reduce body fat.
[27][28] To maintain health, the American Heart Association recommends a minimum of 30 minutes of moderate exercise at least 5 days a week.
[33] The city of Bogota, Colombia, for example, blocks off 113 kilometers (70 mi) of roads every Sunday and on holidays to make it easier for its citizens to get exercise.
[4][12] Weight loss programs involve lifestyle changes including diet modifications, physical activity and behavior therapy.
These programs also enable people to connect with a group of others who are attempting to lose weight, in the hopes that participants will form mutually motivating and encouraging relationships.
Study authors suggested that one explanation for the difference is that group participants spent more time with the clinician (or whoever delivered the programme) than those receiving one-on-one support.
[12][15] Moderate on-site comprehensive lifestyle changes produce a greater weight loss than usual care, of 2 to 4 kg on average in 6 to 12 months.
[52] The Transtheoretical Model (TTM) has been used as a framework to assist the design of lifestyle modification programmes, including weight management.
A systematic review found that there is insufficient evidence to draw conclusions regarding the effects of TTM-based programs targeting weight loss that included dietary or physical activity interventions, or both (and also combined with other interventions), on sustainable weight loss (one year or longer) in overweight and obese adults.
As every operation may have complications, surgery is only recommended for severely obese people (BMI > 40) who have failed to lose weight following dietary modification and pharmacological treatment.
Bariatric surgery, particularly Roux-en-Y gastric bypass and sleeve gastrectomy, have demonstrated effectiveness in promoting weight loss and improving diabetes outcomes among severely obese individuals.
[95] As such, managing it requires changes in the wider societal context and effort by communities, local authorities, and governments.
[96] Public health efforts seek to understand and correct the environmental factors responsible for the increasing prevalence of obesity in the population.
[99] When constructing urban environments, efforts have been made to increase access to parks and to develop pedestrian routes.
Campaigns might also be able to reduce the amount of time spent sitting or lying down and positively affect the intention to be active physically.
In a clinical practice guideline by the American College of Physicians, the following five recommendations are made:[109][needs update] A clinical practice guideline by the US Preventive Services Task Force (USPSTF) concluded that the evidence is insufficient to recommend for or against routine behavioral counseling to promote a healthy diet in unselected people in primary care settings, but that intensive behavioral dietary counseling is recommended in those with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease.
[5] The European Union published clinical practice guidelines in 2008 in an effort to address the rising rates of obesity in Europe.
