Weight management: Challenge and opportunity

The economic impact of obesity-related chronic diseases is substantial. Researchers estimate that in the United States 2016, these accounted for nearly half a trillion dollars direct health care costs. In further estimates, obesity was responsible more than $1.2 productivity two major self-care approaches to weight management are adoption healthy lifestyle (e.g., diet and exercise habits) pharmacologic therapy (nonprescription products dietary supplements). A combination often used. Treatment goals 1) improved control comorbid conditions associated with overweight obesity, 2) improvement psychological feelings well-being, 3) cosmetic benefit. Pharmacists have wonderful opportunity contribute patient success this area. term “lifestyle intervention” describes strategy change, physical activity, behavior therapy. Dietary modification or restriction mainstay loss Physical activity less effective producing initially but important maintaining improving overall fitness. One key implement interventions sustained over long period time. Support for, access to, intervention programs should be included array services available from today's providers. Cutting portion sizes, switching water soda, using smaller plates meals, keeping snacks such as fruits vegetables on hand useful, sustainable strategies. Overall, U.S. population suffers “portion distortion,” people need relearn appropriate food sizes based age levels. individually planned designed create deficit 500 kcal/day an integral part any program. Structured commercial very popular. seen likely at least partially due social support develops periodic meetings. Online tools diaries groups increasingly available; resources may expensive structured community-based programs. Encouraging prevent becoming public all groups. Behavioral therapy, used other strategies, can improve outcome Remote coaching mobile technologies methods encouraging adherence modifications. techniques include self-monitoring weight, use pedometers scales, problem solving identify barriers maintenance. Pharmacologic nonprescription agents short-term measure unless overseen by provider. Orlistat benefit adjunct changes helping patients lose modest amount weight. Adverse GI effects decreased absorption fat-soluble vitamins concerns. Also, some concern has been raised about orlistat misuse, so watch repeated purchases individuals, primarily adolescent group. Many supplements promoted contain multiple ingredients, including minerals, several purported actions. Often “proprietary blends,” which not specific amounts, must listed. Most clearly demonstrated safe, many serious adverse effects. Health providers advised determine risk reactions drug–supplement interactions. Adulteration concern, sibutramine, prescription medication voluntarily withdrawn Canadian markets because its significant cardiovascular risks. Those who self-treatment plan persons considered severely obese (BMI ≥ 40), women pregnant breastfeeding, younger 18 older 65. Individuals disease, diabetes, hypertension, dyslipidemia those eating disorder also avoid plan.