By Mark Gurarie 

 Medically reviewed by Lindsay Cook, PharmD

Obesity is a chronic condition characterized by excess fat cells in the body. It’s traditionally defined as having a body mass index (BMI) of 30 or above, though this scale has limitations.¹ Between 2017 and 2020, 41.9% of Americans were living with obesity.²

Obesity is considered a disease because it can lead to numerous adverse health effects, including diabetes, heart disease, stroke, and high blood pressure, among others.² There are a wide variety of treatment options to help you lose weight. Treatments include nutrition, exercise, medications, procedures, and other therapies that help people lose excess weight.

This article will touch on all of the treatment options so you can determine which is right for you. 

Dietary Changes

Changing your diet can be critical for promoting weight loss. You gain weight when you consume more calories than you need. Hence, your healthcare provider may recommend diet changes to reduce energy (calorie) density while ensuring you get the necessary vitamins and nutrients.³ They may refer you to a registered dietician (RD) to provide a personalized dietary plan to meet your needs.

A healthcare provider may recommend one of two evidence-based approaches to diet patterns, including the Mediterranean and Dietary Approaches to Stopping Hypertension (DASH) diets, which emphasize fruits, vegetables, whole grains, healthy fats, and lean protein.⁴

Physical Activity

Alongside dietary changes, increasing physical activity helps you burn more calories. As such, healthcare providers frequently recommend adopting a regular fitness regimen alongside nutritional changes.

Adults should get 150 to 300 minutes of moderate-intensity activity a week, such as brisk walks or jogging. Alternatively, you can aim for 75 to 150 minutes of high-intensity exercise, such as running, weightlifting, soccer, and jumping rope. You can also combine moderate and high-intensity activities.⁵

Behavioral Modifications

Behavioral modifications and therapies can help you take on weight-associated stigmas and support you in making lifestyle changes to manage obesity. Certain behaviors—such as how much you eat, your eating patterns, and what you associate eating with—all influence weight status. Behavioral modification therapy aims to recognize these and develop strategies to promote exercise, diet, and weight loss goals.⁶

Kelley CP, Sbrocco G, Sbrocco T. Behavioral modification for the management of obesity. Prim Care. 2016;43(1):159-175. doi:10.1016/j.pop.2015.10.004

 Obesity

Weight Loss Medications

A healthcare provider may prescribe certain medications to assist in obesity management. They don’t work alone and must be taken alongside exercise, dietary, and behavioral modifications. Several of these are available in the United States, including Saxenda (liraglutide), Xenical (orlistat), Qsymia (phentermine-topiramate), Wegovy (semaglutide), Contrave (naltrexone-bupropion), and Zepbound (tirzepatide), among others.⁷

Hormonal Treatment

Hormones in the gut regulate your body’s sense of fullness and are released to signal your body to stop eating. Injections boosting these levels, alongside other interventions, can reduce your caloric intake and alter your food preferences. Approved hormonal treatments in the United States include Saxenda (liraglutide), Wegovy (semaglutide), and Mounjaro (tirzepatide).⁸⁹

Surgery

A healthcare provider may consider treating obesity with surgery when other therapies or treatments haven’t yielded results. Surgeries to treat obesity can reduce the amount of food you can digest at any one time, leading to calorie restriction. Alongside dietary and exercise changes, gastric sleeve, gastric bypass, and gastric band surgeries can lead to significant drops in weight.¹⁰

Devices

Healthcare providers surgically implant several devices to promote weight loss by reducing digestive capacity. Several devices approved for use in the United States work similarly to gastric surgeries. Many people opt for devices because they are less invasive than surgeries to treat obesity, and many of these devices can be removed or the procedure reversed if your goals no longer align with the intended use of the device.¹¹

Browning White Fat Cells

There are three types of fat in your body:¹²

• White adipose tissue (WAT)

• Brown adipose tissue (BAT):

• Beige adipose tissue (newly discovered)

WAT comprises the majority, forming as sugars break down to form fat content. BAT is brown and helps the body keep warm when cold, burning calories. In turn, beige adipose tissue resembles BAT and forms as WAT cells “brown.”¹²

Studies have found that increasing the activity of BAT and beige adipose tissue can increase weight loss. This is done by exposing your body to lower temperatures (typically 66 degrees) for two hours, which causes the release of norepinephrine and irisin. Boosting exercise levels can also have this effect.¹²

Additionally, some medications used for obesity and diabetes, such as Avandia (rosiglitazone), glucagon-like receptor 1 (GLP-1) agonists like Trulicity (dulaglutide), or Saxenda (liraglutide), among others, can also promote the browning of WAT.¹²

Are Off-Label Drugs a Good Obesity Treatment?

Though not approved by the Food and Drug Administration (FDA) for obesity, several medications used to treat other conditions may help promote weight loss. Administered under the direction of your healthcare provider, this is called an “off-label” drug use. For obesity, there are several such drugs:¹³

• Ozempic (semaglutide): An FDA-approved medication for type 2 diabetes¹⁴

• Glucophage (metformin): This anti-diabetic drug is used off-label as an adjunct to other weight loss therapies.

• Topamax (topiramate): A drug used for epilepsy or migraine, Topamax can spur weight loss.

• Mounjaro, Zepbound (tirzepatide): Another anti-diabetic drug, Mounjaro can also promote weight loss. Tirzepatide is also the active ingredient in Zepbound, which is approved to treat obesity.

• Victoza (liraglutide): This anti-diabetic drug containes the active ingredient liraglutide. Liraglutide is the active ingredient in Saxenda, which is approved to treat obesity.

Health Risks Associated With Weight

Excess weight and obesity can significantly impact your health. These issues raise the risk of numerous diseases and health conditions, including:¹⁵

• All-cause mortality (premature death)

• High blood pressure (hypertension)

• High LDL (“bad”) cholesterol and triglycerides (dyslipidemia) and low HDL (“good”) cholesterol

• Type 2 diabetes

• Coronary heart disease or coronary artery disease

• Stroke

• Gallbladder disease

• Osteoarthritis

• Sleep apnea (breathing difficulties when asleep, causing snoring)

• Several types of cancer

• Mental health disorders, including anxiety and depression

• Pains, aches, or injury to the joints

What’s the Best Treatment for Obesity?

There is no singular “best” approach to obesity. Each medical approach has advantages and disadvantages, requiring lifestyle changes to achieve lasting results. It can take multiple attempts or methods to get results. Researchers have found that about half of those who’ve lost weight regain what they lost within two years, with this climbing to 80% of people after five years.¹⁶

This means that, when considering your options, you’ll need to find the right combination of methods that work for you. Since there’s much misinformation and marketing about weight loss approaches and products, the best bet is to talk to your healthcare provider. They’ll be able to help you find a plan that enables you to achieve and maintain weight loss.

Summary

Obesity and excessive weight can cause serious health problems, making weight management a critical component of overall health. Obesity treatments include changing your diet, physical activity, medications, and behavior and considering surgeries and other devices when other treatments are ineffective.² Ultimately, the most successful treatment will best fit your lifestyle and goals; talk to your healthcare provider about your options.