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From being unusual condition in 1970s, prevalence of severe obesity is increasing in several developing countries. If current trends continue, we will face epidemic of severe obesity. Severe Obesity is important attend to, regarding population health and in clinical encounters. Obesity - related issues may vital life functions and limit lifespan. Health risks rise with increasing body weight, and obesity is related to coronary heart disease, hypertension, type 2 diabetes, musculoskeletal some cancers, depression and anxiety. Experiences, meanings attitudes attached to obesity differ profoundly according to severity. Social stigma, discrimination and withdrawal from social life loved ones are consequences for many. Weight stigma is part of clinical encounters, and health care providers are necessarily reflective about this. Weight stigma in clinical encounters is paradox, because stigma affects patients ' health and quality of life negatively, and undermines trust between patients and health care providers. This means that health care providers and patients encounter tension between supporting initiatives towards weight loss and change, and risk of enacting stigma and affecting health negatively. People's live experiences can yield rich examples to help understand long - term weight loss in concrete ways, and providing in - depth contextual understanding may guide professional action and strengthen engagement in clinical encounters. Aim Of Current Study Was To Describe Lived Experiences Of Adults Who Have Been Severely Obese, Have Lost Weight And Sustained It Over Period Of At Least 5 Years. Lifestyle change, cognitive behavioural therapy, weight loss medications and bariatric surgery are strategies for severe obesity. Weight loss surgery is most effective intervention for long - term weight loss, but carries risk of mortality, complications and late effects, and health outcomes are largely unknown. Surgery is not option for all patients, because of individual preferencesfor example, avoiding risks or advocating fat acceptanceor societal barriers, such as financial or health system barriers. Modest weight loss, 5 - 10 percentage of initial body weight, is sufficient to significant health benefits and prevent Obesity - related illness. Whether modest weight loss is experience is may depend on initial size, weight and health. Non - surgical weight initiatives for people suffering from severe obesity typically aim for loss of 20 percentage or more to achieve health benefits. Approximately 20 percentage of those who obtain loss maintain it for one year or longer. Many terminate weight loss efforts in early phase, and weight regain is frequent. This means that long - maintenance of weight loss via lifestyle changes is possible, but difficult. National Weight Control Registry Has Identified Successful Weight Loss Maintainers And Described Their Strategies, Health Behaviours And Body Weight Trajectories Since 1993. Participants with larger initial weight loss have been most successful in long term. Successful participants regain more rapidly, but regain very little after five years, and heavier participants follow same pattern.
Results of direct pairwise meta - analysis are summarized in 3 and eFigure 3 in Supplement. All agents were with higher proportions of patients achieving at least 5 percentage and at least 10 percentage weight loss compared with placebo. Overall, excess weight compared with placebo was 2. 6 kg with orlistat, 3. 2kg with lorcaserin, 5. 0 kg naltrexone - bupropion, 8. 8 kg with phentermine - and 5. 2kg with liraglutide. All agents more frequently discontinued because of adverse events than placebo. Significant heterogeneity was observed for most comparisons, but difference was primarily in magnitude of effect size, not in direction. In head - to - head comparison, liraglutide results in greater weight loss compared orlistat, with no difference in adverse events. 49 in post hoc sensitivity analysis using Hartung - Knapp method, all results were consistent.
One of methods that has been used lot for preventing weight gain is meal replacement. It is safe, efficient, cost effective, and without any side effects. In this method, level of compliance is better, receipt of nutrient intake is sufficient, and drop - out rate is low. Calorie Density Of These Meals Is Controlled And They Are Also Nutrient - Dense. Main meals snacks can be replaced by these nutritionally balanced low - fat meals. Table 1 meal replacement trials for weight maintenance. Lecheminant and his colleagues use liquid form of very low energy t for weight loss. Subsequently, they randomize participants to receive structured meal plan combined with either two - meal replacements or orlistat and physical activity. There was no significant difference weight change between groups during weight maintenance. In another study, adults were assigned to Medifast's meal replacemen't or self - select, isocaloric, Food - base meal plan for Weight Loss and weight maintenance. Amount Of Weight Regained Was More In MD Group, But Percentage Of Participants Who Kept Up Their Weight In This Group Was More Than In Other Group. In prospective intervention, 100 patients randomly went on one of two dietary interventions for Weight Loss: Group, which consists of energy - restrict diet, and Group B, which includes isocaloric diet, through which two meals per day were replace. Next, patients were ordered same calorie diets and had only one replacement per day for four years. Body weight was reduced in both groups in Weight - Loss period, but Group B had greater change and maintained their weight better. Meal replacement based dietary intervention compared to structured diet and exercise program for both Weight and maintenance had no distinctive influences on appetite, fullness, diet satisfaction, and quality. Structure diet groups lose significantly more weight and maintain greater loss, but they report more physical activity too, that may have affected results. There are some limitations when this method. First of all, in most studies are volunteers and so more motivated. Second, they not be able afford meal replacements. Finally, using same meals every day can bring out dietary fatigue.
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