Currently, obesity is no longer viewed only from an aesthetic point of view, and sunk to the level of medical problems. This is due to the fact that obesity is associated with increased mortality and diseases such as hypertension, hyperglycemia, dyslipidemia, coronary heart disease, osteoarthritis, gallbladder disease, sleep apnea and certain cancers (breast, prostate, endometrium, colon ). For example, over 50% of Americans can be classified as overweight people and obesity. As a result, the expected mortality in the United States could increase to 300,000 per year. After all, despite the fact that it is not known the exact mechanism of communication by which obesity contributes to hypertension, estimated population studies, at least 75% of cases of hypertension associated with obesity. In the literature there is ample evidence that blood pressure increases with weight gain and decreases with its loss, as well as responsible for the activation of the sympathetic nervous system, which can ultimately lead to a change in the structure and function of the kidneys. Obesity also influences the metabolism of lipoproteins. Weight gain leads to increased levels of triglycerides and low density lipoprotein (LDL), and decreased high-density lipoprotein (HDL). By reducing the weight indicated the opposite effect on the level of lipoproteins in individuals with overweight. This relationship is also observed in the sensitivity of insulin receptors in diabetes mellitus type 2. More than 50% of the insulin sensitivity is directly related to obesity. As the weight increases insulin resistance, with marked improvement in weight reduction glycemic control.

The examination of patients with obesity should be assessed three indices: body mass index (BMI), waist circumference and the absolute risk status. BMI - a measure of the relationship of height and weight, it is calculated as the ratio of body weight in kilograms by the square of height in meters. In June 1998 the National Institute of Health (USA) (The National Institutes of Health - NIH) approved clinical guidelines for diagnosis and treatment of obesity. This guide identifies people with overweight as a BMI 25-29,9 kg/m2 with obesity who have BMI of 30 kg/m2 and above.




The guidance emphasizes that patients 18 years or older with a BMI of 25 kg/m2 and above have a higher risk of developing secondary complications such as hypertension, type 2 diabetes, coronary heart disease and hyperlipidemia.

Waist circumference is an indicator of the degree of abdominal (central, visceral) obesity. Proved that the central type of obesity is an independent risk factor associated diseases. The three groups include individual factors of cardiovascular risk according to the classification proposed by the NIH:

1. Patients with comorbidities such as type 2 diabetes, coronary heart disease, other diseases associated with atherosclerotic vascular lesion, the syndrome of "sleeping apnea, are a group with a very high risk of complications and mortality.

2. Patients with three of the following factors of cardiovascular risk: hypertension (systolic blood pressure> = 140 mmHg or diastolic blood pressure> = 90 mmHg or receiving antihypertensive treatment), dyslipidemia (LPNN> = 160 mg / dL or HDL <35 mg / dL), impaired fasting glycemia (110-125 mg / dL), smoking, weighed down with a family history of cardiovascular disease at a young age (myocardial infarction or sudden death at the age of <= 55 years with his father or his brother, or <= 65 years, mother or sister), age (men> = 45 years and women> = 55 years or postmenopausal), belong to a group at high risk.

3. Patients with other diseases such as gynecological pathology, osteoarthritis, cholelithiasis.

NIH recommends that patients with a BMI ≥ 30 kg/m2, as well as patients with a BMI of 25 to 29.9 kg/m2, or men with a waist circumference of more than 102 cm and women - more than 88 cm, with two or more risk factors listed above, to reduce weight. The initial aim should be to lose 10% of initial body weight over 6 months. It can be achieved through lifestyle modifications, which includes a diet with reduced caloric intake and increasing physical activity. If lifestyle changes are not enough to achieve the goal or not allow to maintain the result achieved for a long time, it is possible appointment of pharmacotherapy. Over the last few years arsenal of drugs for weight loss decreased. Fenfluramine, DexFenfluramine, phenylpropanolamine withdrawn from sale because of serious side effects. To date, only sympathomimetics sibutramine and orlistat approved by the Food and Drug Administration (FDA), as preparations for weight reduction. The choice of drug depends on comorbidity and therapy, ease of use and value. Before you assign a particular drug, the physician must know the full details of the currently available different classes of drugs used for weight reduction, their pharmacodynamics, side effects and possible interactions with other drugs.










Many studies have shown that even a modest weight loss reduces the risk of cardiovascular and other complications. The recommendations for the treatment of obesity indicates that the primary goal of treatment is the loss of 5-10% of body weight and maintaining weight achieved, rather than achieving the ideal body weight. If, within 6 months unable to reduce their weight by 5-10% through diet, exercise, lifestyle changes, it is advisable the appointment of medical therapy, especially patients with risk factors such as hyperlipidemia, hypertension, diabetes mellitus. Although medical therapy leads to a loss of only 5-15% of body weight in most patients, even a reduction in weight leads to significant improvement in health status. In addition, as noted above, several studies suggest that medical therapy in combination with modification of food increases the farther the effectiveness of treatment of obesity and enables long-term maintenance of body weight after the reduction.


Patients choose medical therapy, it is necessary to clarify that obesity is a chronic disease. Therefore, to prevent a return to the original weight, they need long-term treatment [37]. In this regard, for patients with obesity phentermine not be a first-line drugs, since most patients quickly develop tolerance to its therapeutic action. Because orlistat and sibutramine are suitable for prolonged use and their therapeutic effect persists for at least 1 year, they are the drugs of choice for the treatment of obesity.

Deciding on the appointment of medical treatment of obesity should take into account the presence of concomitant diseases and concomitant drug therapy.

The main target of obesity combat is not simply to drop a few pounds, but mainly to maintain weight, the weight which will be healthy for you. In many cases people believe they must lose much more weight, than they need in fact.

If you quality as obese based on BMI and your weight is 200 pounds, then you need to lose 10-20 pounds in order to make weight loss safe and harmless. It doesn’t mean you don’t need to drop more pounds, but this is how you must start this process. Please mind that the loss of 1-2 pounds a week is the best resolution with no harm to your health.

There exist three basic approaches to losing weight, namely diet, physical activity and behavioural approach. In addition, based on your unique case, the physician can advise you to use some specific weight loss methods, for example weight loss pills or weight-loss surgery.

Changing Diet in some respect sounds pretty simple as everyone understands that the main key to losing weight is eating less fatty food and consuming less fizzy drinks. Therefore you should first of all lessen the consumption of high-calorie products.

At the same time increase the amount of fibre food consumed, such as fruits, vegetables and grains. Choose different ones to keep your ‘taste tank’ full.

However, we would recommend you to consult your doctor as for the diet, since it will greatly facilitate the process of losing weight and will ensure you that your new eating habits will not threaten your health.

Taking into account the above, please do not forget that your body is a complex mechanism, it needs time to get used to any new process, therefore a sudden cut of calorie amount is not recommended, as it might lead to the lack of vitamins. It’s logical that when you start losing weight, the first component which you lose is water, which is not good at all. Be reasonable.

Liquid Diets such as Medifast and Optifast are usually recommended for very obese people. They give no more than 800 calories a day, while an adult consume 2,000 to 2,500. Nevertheless these low calorie diets have one peculiarity, if you stop using them, then you regain weight as rapidly as you lost it.

You probably know Slim-fast liquid meal, which you can buy without a doctor’s prescription. It cuts calories in-take. They suggest that in stead of having a usual meal you should drink their low-calorie shakes, and then have some vegetable snack and the last meal must contain the least fat and calorie amount. This liquid diet proved to be as effective as any low calorie diet is.

Physical Activity is a 100 % natural weight loss treatment method. Since when you move, you burn calories stored in your body. One pound of fat equals to 3,500 calories.

Eat daily 250 calories less, move more and you will likely to lose 1-2 pounds within a week.

Luckily, there is a wide range of sports, everyone can choose according to his preferences and physical abilities.

But what really important is to keep to a certain plan, to make exercises your daily duty, even if it’s a 30 minutes walk. You will not lose weight if you exercise 10-20 minutes one time a week. You must mind periodicity and intensity of physical activity.

Behavioural approach. What’s more important is how much you move in your daily life. Stop being a couch potato, in stead do some cleaning, work in the garden, play with children. In a nutshell, move as much as you can. Don’t let fat be accumulated on your waist line.

Weight loss pills, is a way out for those who for some reason failed to succeed in losing weight using the above approaches. The reasons can vary. Starting from a great BMI (more than 30) to complications aroused by obesity.

If this is your case, then you should know that the below weight loss medications have been approved by FDA (Food and Drug Administration). They are based on different approaches, so you are to choose which one you prefer.

Orlistat (Xenical) works my making fat not absorbable in your intestines. Most dieters lose 6 pound within a year on average. If you decide to take this drug, your doctor will prescribe you to have some vitamins. However, you can buy it without a doctor’s prescription as it’s the over-the-counter weight loss pills. Please note that is goes like a supplement, not a substitute to special diet and exercises.

Sibutramine (Meridia) makes you feel full, so that you don’t want to eat. It’s about your brain chemistry. The results are good enough; most dieters lose about 10 pounds a year, which is more than those who followed a special diet and did exercises.

No matter which of approaches works for you, you must remember that you should not stop. It’s rather difficult to lose weight, but very easy to regain it. If one method doesn’t help, try another one. You will finally find the best combination of behavior and supplements which will make you closer to your dream body.