Management of obesity - options, effectiveness and perspectives

Weight reduction is an obvious aim of the obesity treatment. However, modern obesitology emphasises prevention of complications associated with obesity and improving the quality of life of obese patients. Consequently, obesity is a difficult to treat disease with respect to permanent weight reduction and easier to treat condition with respect to the quality of life. Life style changes usually fail as a treatment option, unless they are accompanied with personally demanding psychotherapy and motivational support. Compliance with the requirements for diabetes prevention is effective even without weight reduction. Treatment with anti-obesity medication and bariatric surgery are also associated with long-term effectiveness. However, orlistat is the only anti-obesity agent currently available. New anti-obesity medication with central effect that would replace no longer used sibutramin, are expected to reach clinical practice in a few years. The effect of incretin analogues on weight reduction also provides hope. Physical activity has the best effect on obese patients' prognosis. Nonetheless, the future of obesity treatment is mainly associated with pharmacotherapy and new technologies, e.g. gastric stimulation.

Keywords: obesity; quality of life; diabetes prevention; anti-obesity agents; incretin analogues; bariatric surgery; gastric stimulation