Treatment

General Considerations
Since obesity is so common and produces so few symptoms in its earlier stages, it remains a personal but socially acceptable problem for most patients; scarcely seeming to merit the major effort involved in its correction.

For a previously obese person to maintain a normal weight often demands persisting indefinitely with some dietary restrictions, even when the target weight has been has been attained, the majority of patients are unable or unwilling to sustain the effort required.

The very high relapse rate, as much as 80 percent, among patients who may have reduced their weight appropriately, is a clear indication of the intractable nature of the disability. The most important single requirement in the management of obesity is education of the patient. The more they can be taught about the nature and behaviour of the problem, the more likely are they are to succeed.

This makes heavy demands on the time, energy, skill and enthusiasm of the doctors and dietitians, who arc called upon to supervise these patients. Most have already made attempts to reduce their weight either on their own, or on their doctors advice, or as frequently happens now, with the support of lay groups established for the express purpose of helping patients to diet.

The basic requirement for the treatment of obesity, whether it occurs in infants, children or adults, is the regulation of the daily intake of energy sources. In the first instance an unweighed diet is used, but if this is not effective, the stricter discipline of a weighed diet may need to be imposed for a time.

Obese patients who fail to respond to any of these measures require further investigation from both physical and psychological aspects and intensive treatment under strict supervision.