EMERGING MANAGEMENT STRATEGIES FOR OBESITY

Management strategies for obesity, which include drug therapy, are eme rging as a consequence of the increasing recognition of the medical se riousness of obesity. Obesity requires appropriate and effective manag ement by suitably trained members of a multidisciplinary team, with tr eatment programmes putting equal importance on weight reduction and it s maintenance. Such programmes must also take into account the reducti on in risk from co-morbid conditions after modest weight loss (5-10% o f initial body weight). The use of an anti-obesity drug may be justifi ed for patients at risk from obesity where dietary methods, including exercise and behaviour modification, have failed to achieve a 10% redu ction in initial body weight after at least three months from the star t of the episode of managed care. Anti-obesity drugs must be perscribe d in an appropriate setting, with patients being reviewed on a regular basis. Essential elements for managed weight loss include, a printed management programme, appropriate equipment, specified and realistic w eight-loss goals, documentation of individual patient's health risks, and clearly defined followup procedures with explicit guidelines for t he use of drugs and notification of other doctors involved in the pati ent's care. The process of drug treatment necessitates a system of reg ular medical audit. Many health-care professionals and lay persons rem ain sceptical about the scientific value of anti-obesity drugs. The em ergence of increasingly specific and effective agents underlines the i mportance of ensuring appropriate use for patients at risk from obesit y.