Treatment Of Overweight And Obesity (Very Simple)
Treatment:
The two main points of treatment are reducing calorie intake and increasing calorie expenditure. Emphasis is placed on comprehensive treatment based on behavior, diet, and exercise, supplemented by medication or surgery if necessary. Secondary obesity should be treated for the cause. Various complications and accompanying diseases should be treated accordingly.
Behavioral therapy
Through publicity and education, patients and their families have a correct understanding of obesity and its harmfulness, thus cooperating with treatment, adopting a healthy lifestyle, changing diet and exercise habits. Conscious long-term adherence is the first and most important measure of obesity treatment.
2. Control diet and increase physical activity
Those who are mildly obese, control the total amount of food intake, use a low-calorie, low-fat diet, avoid high-sugar and high-fat foods, so that the total daily calories are lower than the consumption. For more physical labor and physical exercise, if you can reduce your weight by 500-1000g per month and gradually reach the normal standard weight, you don't need medication.
Moderately above obesity requires strict control of total calories, and female patients are required to limit food intake to 5 to 6.3 MJ (1200 to 1500 kcal)/d. If it exceeds 6.3 MJ/d, it is ineffective. Men should be controlled at 6.3 to 7.6 MJ (1500 to 1800 kcal) / d, which is expected to lose 1 to 2 pounds per week. Animal foods should contain an appropriate amount of essential amino acids (one-third of the total protein is appropriate), protein intake is not less than 1g per kilogram of body weight per day. Fat intake should be strictly limited, and sodium intake should be limited to avoid water and sodium retention during weight loss, and it is also beneficial to lower blood pressure and reduce appetite. In addition, restrictions on sweets, beer, etc. If the weight of the above diet can not be reduced for several weeks, the total daily calorie can be reduced to 3.4 ~ 5MJ (800 ~ 1200kcal) / d, but the heat is too small, the patient is susceptible to fatigue, weakness, fatigue, mental fatigue Etc., must be closely observed. According to the study, the protein consumption in the early stage of diet therapy is so high that the body weight declines rapidly and the negative nitrogen balance is achieved. When the low calorie diet is continued, the protective nitrogen storage reaction occurs, and the nitrogen balance is gradually reconstructed, so the fat consumption is gradually increased. However, fat production is about 10 times higher than protein, so the amount of fat tissue disappears is significantly less than the amount of protein tissue. When the protein is synthesized in the opposite direction, the body weight can be increased. This is the regulation process of the human body after limiting the heat card. Therefore, diet therapy is often ineffective, and in this case, exercise therapy should be encouraged to increase calorie expenditure.
The formulation of the amount of activity or the amount of exercise should vary from person to person and, in principle, take a step-by-step approach.
3. Drug treatment
For severely obese patients, drugs can be used to lose weight and then continue to be maintained. However, how to better use these drugs in clinical practice remains to be explored. Medications may produce side effects and drug resistance, so the indications for drug treatment must be very careful, and decisions may be made based on the patient's individual condition to measure the benefits and potential risks.
4. Surgical treatment
Empty ileal short circuit surgery, biliary pancreatic pancreatic short circuit surgery, gastric short circuit surgery, gastroplasty, vagus nerve cutting and gastric ballooning are available. Surgery is effective (referring to weight loss >20%) rate of 95%, mortality <1%. Many patients have long-term effects, and preoperative complications can be improved or cured to varying degrees. However, surgery may be complicated by malabsorption, anemia, narrowing of the pipeline, etc., and there is a certain risk. It is only used for severe obesity, weight loss failure and serious complications, and these complications may be improved by weight loss. Preoperative assessment of the patient's general condition, especially diabetes, hypertension and cardiopulmonary function, should be monitored and treated accordingly.
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