The efficacy of drugs, diets and surgery in the treatment of obesity

Obesity has reached epidemic proportions in the United States. According to the Centers for Disease Control (CDC), approximately 61% of the population is estimated to be overwieght (BMI ≧ 25), amounting too as many as 180 million people. The cause of this dramatic rise in obesity is due to a long-term positive caloric balance. However, most individuals are not disciplined in following a program of exercise and dietary restriction, looking instead for a simple or "quick-fix" to their problem. Weight-loss remedics fall into three categories: Drugs, Surgical Procedures, and Diets. Drugs are under two major categories. The most common are those that attempt to suppress appetite, such as Sibutramine, Phentermine, and Mazindol, to name a few. But others are being tested as well. The FDA approved Xenical several years ago, and its mode of action is to block fat digestion/adsorption by inhibiting pancreatic lipase. A starch blocker is also now available. Surgical procedures include intestinal bypass and the current popular fad, gastric banding. This latter technique involves forming a small pouch at the proximal end of the stomach, which allows an individual to feel satiated with smaller amounts of food. The diet category is by far the most numerous, containing many fad diets, such as cabbage soup diet, all fruit diet, and grapefruit diet. The current diet craze in the U.S. is the Atkins diet, which is basically a low carbohydrate and high fat/protein diet. Testimonials for substantial weight loss on this diet are quite extraordinary, but the long-term safety of this dietary program will be discussed. Copyright © 2004 The Hong Kong Institute of Education.