Weight Management:

A Comprehensive Overview

1. Introduction

Obesity is a complex, chronic disease associated with multiple comorbidities, including type 2 diabetes, cardiovascular disease, and certain cancers. Management requires a multidisciplinary approach tailored to individual patient needs.

2. Screening and Assessment

Before initiating treatment, a comprehensive assessment by your doctor usually includes:

• BMI and Waist Circumference: Identify overweight (BMI ≥25) and obesity (BMI ≥30).

• Medical Causes of Weight Gain: Rule out conditions such as:

  • Hypothyroidism

  • Cushing’s syndrome

  • Polycystic ovary syndrome (PCOS)

  • Menopause-related metabolic changes

  • Medications (e.g., antipsychotics, corticosteroids)

• Eating Disorders Screening: Identify conditions such as binge-eating disorder or night-eating syndrome, which require specific interventions.

3. Lifestyle Management

3.1. Diet

An effective weight-loss diet should focus on sustainability and nutritional adequacy. Evidence-based dietary approaches include:

• Mediterranean Diet: Emphasizes fruits, vegetables, whole grains, healthy fats, and lean proteins.

• Low-Carbohydrate Diets (e.g., Keto, Atkins): May benefit individuals with insulin resistance but require monitoring.

• Low-Fat Diets: Historically promoted but now considered less effective long-term.

• Intermittent Fasting: Includes methods such as 16:8 or 5:2, showing benefits in some populations.

• Portion-Controlled Diets (e.g., Meal Replacements): Useful in structured programs.

3.2. Exercise

Physical activity recommendations include:

• Aerobic Exercise: 150–300 minutes per week of moderate-intensity activity (e.g., brisk walking, cycling).

• Resistance Training: At least 2 sessions per week to preserve lean muscle mass.

• High-Intensity Interval Training (HIIT): Effective for improving metabolic health and weight loss.

• Other incidental physical activities is still important to burn calories (eg taking the stairs instead of the lifts)

4. Pharmacological Management

Pharmacotherapy is recommended for individuals with BMI ≥30 or BMI ≥27 with obesity-related comorbidities.

4.1. GLP-1 Receptor Agonists in Australia

GLP-1 receptor agonists have revolutionized weight management.

4.2. Other Pharmacological Options

5. Surgical (Bariatric) Options

Bariatric surgery is recommended for:

• BMI ≥40, or

• BMI ≥35 with obesity-related comorbidities.

6. Multidisciplinary Approach

A team-based approach improves long-term outcomes:

• Dietitian: Personalized meal planning.

• Exercise Physiologist: Tailored exercise programs.

• Psychologist: Address emotional eating and disordered eating patterns.

• GP/Endocrinologist: Medical supervision and pharmacotherapy management.

• Surgeon: For eligible patients considering bariatric surgery.

Conclusion

Effective weight management requires a holistic, patient-centered approach integrating lifestyle changes, medications, and surgery when appropriate. With new pharmacological advancements like semaglutide, tirzepatide, treatment options continue to evolve.

Resources

• Austin weight control clinic: has many great videos and other resources

Related:

• GLP1 agonists, the new kid in the block in weight management