Treatment strategies for overweight and obesity

Abstract

Purpose: To review the health problem of overweight and obesity in adults, the available treatment options, and clinical implications for nursing.

Organizing construct: Overweight and obesity.

Findings: Today, obesity is considered a pandemic that is present in developed and developing countries. Obesity, considered a chronic condition, is associated with numerous comorbid conditions (e.g., cardiovascular disease, diabetes, and some cancers). There are three approaches to the treatment of overweight and obesity: lifestyle modification, pharmacotherapy, and bariatric surgery. The most effective approach uses a combination of behavioral strategies and diet and exercise to support sustained lifestyle change. Pharmacotherapy and bariatric surgery have better outcomes when augmented by lifestyle treatment compared with either approach alone. Bariatric surgery, which is being performed increasingly more often, is reserved for those with a body mass index (BMI) of greater than or equal to 40, or a BMI of 35 to 39.9 in the presence of comorbidities. The biggest treatment challenge is the prevention of weight regain.

Conclusions: The most effective treatment approach is the use of lifestyle modification, which can be delivered alone or to augment pharmacotherapy or bariatric surgery.

Clinical relevance: Similar to other chronic conditions, obesity needs ongoing management, which is a role that nursing can help fill in the clinical setting.