How to lose weight in severe obesity

Severe obesity can be intervened through lifestyle adjustments, medication treatment, metabolic surgery, and other methods. Medical intervention is required when the body mass index exceeds 40 or accompanied by serious complications.

1. Lifestyle Adjustment

Severely obese individuals should establish a daily calorie deficit of 500-1000 calories, adopt a high protein, low carbohydrate diet, and prioritize low glycemic index foods such as chicken breast and broccoli. Perform at least 150 minutes of low impact aerobic exercise per week, such as water walking, stationary cycling, etc., to avoid knee joint injuries. It is recommended to record daily diet and exercise data, and have a nutritionist adjust the plan regularly. Sleep time should be ensured to be 7-9 hours, as insufficient sleep can lead to a decrease in leptin secretion.

2. Behavioral cognitive therapy

corrects abnormal eating behaviors such as overeating through psychological counseling, and can use mindfulness based eating training to reduce eating speed. Establish a non food reward mechanism and replace emotional eating with social activities. Family members need to participate in supervision together to avoid storing high calorie foods. Cognitive behavioral therapy can help identify environmental factors that trigger overeating and has a significant effect on nighttime eating syndrome.

3. Medication therapy

Under the guidance of a doctor, Orlistat capsules can be used to inhibit lipase activity and reduce dietary fat absorption by 30%. Liraglutide injection increases satiety by delaying gastric emptying, but it should be noted that it may cause gastrointestinal reactions such as nausea. The combination of naltrexone sustained-release tablets and bupropion can be used to control the appetite center, and blood pressure changes need to be monitored during use. Drug therapy needs to be combined with dietary management, and the effectiveness of medication alone is limited.

4. Metabolic surgery

Sleeve gastrectomy can reduce gastric volume by 80% and result in an average weight loss of 60% of the overweight portion one year after surgery. Gastric bypass surgery realized weight loss by changing the food digestion path, and the remission rate of type 2 diabetes reached 75%. Surgery requires strict evaluation of cardiovascular and pulmonary function, and lifelong supplementation of vitamin B12 and iron is required after surgery. Monthly follow-up is required within one year after surgery to prevent complications such as dumping syndrome.

5. Multidisciplinary management

Endocrinologists monitor thyroid function and address insulin resistance issues. The rehabilitation department develops a tiered exercise plan to prevent skin sagging. Psychological assessment of psychological issues such as body image disorders. Regular testing of liver and kidney function is necessary during weight loss, as rapid weight loss may trigger gallstones. It is recommended to join a professional weight loss group to receive sustained social support. Severely obese individuals should have their glycated hemoglobin and blood lipids tested every 3 months, and the weight loss rate should be controlled at 0.5-1 kg per week. Choose steaming instead of frying as the cooking method, and use small utensils to control the amount of food consumed at a time. Establish a regular eating schedule to avoid skipping meals and compensatory overeating. Increase non exercise calorie expenditure in daily life, such as standing for work, walking for commuting, etc. If there is difficulty breathing or worsening joint pain, timely follow-up is needed to adjust the plan.