Benefits of Weight Loss and Obesity Treatment
There are no large-scale randomized studies of isolated weight loss (MT) interventions to evaluate the effect of this reduction on reducing the risk of CHD. However, there is enough information from a number of observational studies and small randomized clinical trials for the duration to conclude that a decrease in MT brings significant health benefits. A small (by 5-10%) decrease in MT is associated with a significant improvement in blood pressure in individuals with and without AH. A small decrease in MT improves the lipid profile, reducing the level of TG, increasing the level of HDL cholesterol and slightly reducing cholesterol and LDL cholesterol, as well as increasing glucose tolerance and / or TS. Reducing MT also helps relieve sleep apnea.
However, there is no consistent approach to reducing MT, and the results of lifestyle modifications to reduce MT are disappointing. In the USA, 25% of men and 43% of women try to reduce MT during the year, but the rate of failed attempts is very high. One of the reasons may be that most people trying to reduce MT do not follow recommendations to reduce calorie intake and increase physical activity (FA) to at least 150 minutes a week.
Effective treatment strategies are usually multifaceted, including nutritional counseling, behavioral therapy, increasing FA and psychosocial support. Recent observational and clinical studies have shown that pharmacotherapy and bariatric surgery may be helpful in reducing MT, but long-term success and risk, as well as the cost-effectiveness relationship, have not been fully evaluated.
The ratio of cost-effectiveness. The lack of benefit assessments and the large variability of intervention strategies do not allow an assessment of the cost-effectiveness ratio of programs or interventions to reduce MT.
Recommendations and guidelines. The guidelines developed by the National Heart, the Lung and Blood Institute and the North American Association for the Study of Obesity offer a threefold strategy for reducing MT, which includes calorie restriction, structured physical activity (FA) and behavioral therapy for all patients with an IMT of> 30 kg / m2, for patients with BMI = 25.0-29.9 kg / m2, suffering from CHD or having RF> 2 (see further discussion of interventions using specific FN and nutritional recommendations). For some patients, pharmacotherapy is suitable, and for very obese patients – bariatric surgery.