See treatments to lose weight proven by science – 05/28/2023 – Balance

According to data from the 2020 PNS (National Health Survey), 60% of Brazilian adults are overweight. Obesity affects 26% of this population. Treatments that promote weight loss go through several steps, from changes in lifestyle to surgical procedures.

All of them, however, have better results if accompanied by healthy habits, such as physical activity and a balanced diet. None of the available therapies, however, has a definitive effect.

“The medicine only works while you’re taking it”, says endocrinologist Maria Edna de Melo, a doctor in the Obesity and Metabolic Syndrome Group at the Hospital das Clínicas at USP (University of São Paulo). It is in these cases that the different treatments available give a little push.

For those who want to lose weight for aesthetic reasons, however, the combination of healthy eating and physical exercise is the only recommended treatment. See what experts and scientific studies say about different therapies for obesity and overweight available in Brazil.

Bariatric surgery

It is an intervention that produces rapid weight loss with long-lasting effects. Study shows results can last up to 16 years. The procedure consists of reducing the volume of the patient’s stomach by different methods.

In a review of the main scientific studies on the subject, experts concluded that it is possible to lose about 30% of body mass through the gastric bypass or sleeve method. The first alters the point of attachment of the intestine, while the second removes the curve of the stomach but keeps the intestinal tract intact.

Indicated only for more severe cases, patients with a BMI (body mass index) greater than or equal to 35 with associated disease, or for those with an index greater than 40, are eligible.

In addition to the immediate risks of the procedure, the surgery has a high price in the medium and long term, according to Bruno Sander, surgeon and researcher at UFMG (Federal University of Minas Gerais). Hair loss, vitamin deficiency and anemia are some of the possible side effects.

Semaglutide

Growing in popularity in recent times, semaglutide is the active ingredient in medications such as Ozempic and Wegovy. While the first is indicated for diabetes and widely used off-label in the treatment of overweight, the second was approved by Anvisa (National Health Surveillance Agency) for obesity.

A study sponsored by parent pharmaceutical company Novo Nordisk evaluated the safety and efficacy of semaglutide at doses of 1 mg (Ozempic) and 2.4 mg (Wegovy). The research, carried out with 1,595 obese or overweight participants with type 2 diabetes, showed that the weekly use of 1.0 mg causes an average reduction in body weight of 7%, while the use of the 2.4% dose decreases it on average 9 .6%.

Like other medications, semaglutide can cause gastrointestinal reactions such as nausea, vomiting, diarrhea, dehydration, abdominal pain and constipation. Use requires medical supervision.

Liraglutide

The medicine, sold under the trade name of Saxenda, is capable of promoting the loss of about 7% of body mass after 16 months of treatment, according to studies. Its application is weekly and use with safe medical supervision.

It causes nausea, vomiting, diarrhea or constipation, among other adverse reactions. Side effects are usually transient, and in rare cases can lead to acute kidney failure.

gastric balloon

A non-surgical alternative for weight loss, the gastric balloon consists of a silicone sphere inserted through endoscopy. Its function is to occupy part of the stomach and help the patient achieve the feeling of satiety with less food. The alternative is indicated for patients with a BMI above 27. Studies show that it causes weight loss of up to 11% of body weight.

However, the intervention has an expiration date: the balloon must be removed within 12 months. This means that, without changes in lifestyle, the patient can regain weight after a period.

“It is a temporary method, a characteristic that does not match a chronic disease like obesity”, says Melo. Therefore, after removal of the prosthesis, the patient is usually referred for drug treatments or, in severe cases, for bariatric surgery.

Sibutramine

Developed as an antidepressant, the drug not only decreases the desire to eat, but also keeps the patient’s levels of energy expenditure regular.

Among all the alternatives available today in Brazil, it is the medicine with the oldest registration, from 1998, and 13 manufacturers have authorization for its production. Clinical studies indicate that the drug is capable of promoting a 10% weight loss in 6-month treatments.

bupropion and naltrexone

The combination of substances, sold under the trade name Contrave, provides an average loss of 10% of body weight after a year of treatment, according to clinical studies.

Naltrexone is also used to treat alcohol and opioid addiction, while bupropion was originally developed for depression and smoking.

The combination, however, can cause high blood pressure, liver disease, hepatitis, manic episodes, agitation, hallucinations, eye problems, and hypoglycemia in people with diabetes.

orlistat

Capable of reducing the absorption of fat by the patient’s body by about 30%, it acts directly on the intestinal enzymes. Approved in Brazil since the late 1990s, it can be produced by 10 different laboratories.

The drug allows you to reduce body mass by up to 10%, according to a study. It may, however, cause gastrointestinal problems as an adverse reaction. Despite this, it is considered a safe drug, and scientific evidence shows that only 6% of patients abandon treatment due to side effects.

diet and exercise

Can’t escape. To lose weight, a person needs to adopt a balanced diet and move around. Even other interventions, whether surgical or medication, require changes in habits for more effective results. This is the only recommended method for those who want to lose weight for aesthetic reasons.

Reviewing scientific studies, researchers concluded that the association of a healthy diet and physical activity causes a reduction of almost 5% of body mass between 1 and 1.5 years of practice, with results that can last for up to 10 years.

“Physical activity, combining aerobic and resistance exercise, should be more than a recommendation, it should be a prescription”, says Melo.