How Is Obesity Treated?

Written by Madeline Laguaite
Medically Reviewed by Brunilda Nazario, MD on January 06, 2023
6 min read

Treatment plans for obesity often combine a lower calorie diet, more physical activity, and medication. If you have obesity, many treatment options can help you lose weight. Doing so lowers your chances of getting diabetes, heart disease, stroke, high blood pressure, and other conditions.

Losing excess weight looks different for everyone. Some people chose a treatment that focuses on nutrition, exercise, or both. There are also options like medications, procedures, and other therapies that have helped others lose weight.

Obesity is a chronic and progressive medical condition. The CDC defines obesity as having a body mass index of 30 or higher. Obesity can impact your health in many ways. Losing weight can lower your BMI and put you closer to what’s considered a healthy weight range.

Before you explore obesity treatments, it’s a good idea to know if your body weight is above normal. Here are some ways your doctor or other healthcare professional can help you tell if you have obesity.

Doing a physical exam

Stepping on the scale gives you your current weight. Your doctor or healthcare professional will likely do a physical exam.

Checking for other problems

They may do lab tests checking for an underactive thyroid, liver problems, or diabetes. This can help you better understand your overall health and customize an obesity treatment.

Recording your health history

Your healthcare professional may ask about:

  • Your weight history
  • Any past weight loss efforts
  • How you exercise and how often
  • What your eating patterns are like
  • If you have support systems and what they’re like

Your doctor might want to know about existing diseases and conditions, too. They’ll ask about the medications you take and check if any may hinder weight loss. You'll also review your general health and the health of your family members, including your parents and grandparents with your doctor.

Measuring your waist

You may have a higher risk for certain health conditions based on your waist size or its circumference. Fat in organs in this area (known as visceral fat or abdominal fat) can raise your risk for certain diseases and conditions. 

Women whose waists are over 31.5 inches and men whose are over 37 inches may have a greater chance of certain health conditions. But waist circumference is just one measurement, and may be less accurate in some situaiton and for certain groups of people.

Determining your BMI

The CDC classifies obesity based on BMI, which is linked to (but not a direct meausre of) body fat. It can be helpful when checking for obesity, but it’s not a tool used solely to diagnose obesity. According to this number, if your BMI is:

  • Less than 18.5, your weight is in the underweight range
  • 18.5 to 24.9, your weight is in the healthy weight range
  • 25 to 29.9, your weight is in the overweight range
  • 30 or higher, your weight is in the obesity range

BMI is interpreted differently in children and teens, even though the same formula is used. This is because the amount of body fat changes with age and is different in boys and girls.  

For adults, there are three categories that define obesity:

  • Class 1: A BMI of 30 to 34.9
  • Class 2: A BMI of 35 to 39.9
  • Class 3: A BMI of 40 or higher (sometimes called severe obesity )

Being aware of your BMI can help guide your obesity treatment options. Because of known health risks associated with extra body weight, anyone with BMI above 25 is a candidate for weight-loss and weight maintenance interventions.

But keep in mind that BMI is not a perfect measure. The link between BMI and your health risk isn’t consistent. It can also depend on your ethnicity, age, and sex. More recent research relies on body composition, and how much fat, bone, and muscle is in your body. That’s because body composition is a more accurate measure of body fat and lean body mass.

Diet and lifestyle interventions are key to losing and managing weight long term. But there are also options such as drugs, devices, and surgeries.

Medications for obesity

There are a lot of prescription and nonprescription medications on the market for weight loss. But doctors may only prescribe medications if you have a BMI over 30 (or if it’s at least 27 and you have a weight-related issue like high blood pressure or diabetes). 

Studies show that people who combine healthy eating and exercise with these medications can have better results than just taking the meds alone.

The FDA has approved many drugs for weight loss, including:

Diet for weight loss

Making sure you get proper nutrition is important to keep your body running well. It helps with weight loss, too. You don’t have to go on a formal diet to lose weight. But there are diet programs that support weight loss, too. Or, you can make small changes to what you eat.

In general, cut down on how many calories you eat to lose weight. Talk to your doctor to see how many calories you should be taking in each day, based on your obesity treatment you use. 

Ask how to make sure your body also gets the nutrients it needs to work at its best. For example, if you have weight loss surgery, you’ll probably eat differently than if you’re trying to lose weight with diet alone.

Exercise and stay active

Being active can help your body lose extra weight by burning calories and it helps prevent muscle loss. Many people use diet and exercise to lose weight. Working out offers general health benefits, too. Likewise, being less sedentary is linked to improved health outcomes. Regular exercise helps keep the weight off. 

Behavior changes

Support groups and individual counseling can help some people lose weight. You may change behaviors linked to the way you eat and move, or identify ways to overcome other obstacles to weight loss

Surgery for obesity

Several types of surgeries, such as gastric sleeve and gastric bypass, can help people who have obesity to lose weight. Many doctors will consider surgery only if you haven’t been able to lose weight using other obesity treatments, or if you have a high risk of getting other weight-related health problems. 

Devices for weight loss

Intragastric balloon devices are approved for use for up to six months. They’re inserted and removed through an endoscope. If you choose one of these, you’ll be under anesthesia during the procedure. These devices decrease calorie intake by increasing a sense of fullness. 

Plenity is the brand name of a prescription capsule for weight loss that is considered a medical device. The capsules contain a hydrogel that is taken with water before eating They expand in your stomach and make you feel full, then come out as waste. It’s a good option for people who aren’t eligible for surgical treatments.

A few drugs are FDA-approved to treat other conditions, but they’ve helped people with those conditions lose weight. Your doctor may prescribe one of these drugs, even if you don’t have the condition the drug is approved to treat. 

These are called off-label uses. Your doctor may combine drugs for weight loss or may have you stay on a medication longer than the directions say. Some of the medications prescribed for weight loss on an off-label basis are:

Metformin. Studies have found that people without diabetes who took this diabetes medication had a lower BMI. One study found that the mean (average) percentage of weight that people were able to lose and keep off, compared to their starting weight, was around 6%.  

Topiramate. Also found in the approved medication, Phentermine-topiramate (Qsymia), some doctors use topiramate alone. Several studies and clinical trials have found this anticonvulsant drug to be effective for weight loss. One trial found that a study group lost up to 9.7% of their body weight in less than a year. But topiramate comes with side effects that include memory and language problems and depression. 

There’s no one treatment for obesity that’s “best.” Finding something that works for you can depend on a lot of things, including your lifestyle and general level of health.

Talk to your doctor or other healthcare professional to come up with a treatment plan that works for you. They can advise you on which treatments these may be, based on your health status, and let you know about any new or upcoming treatments for obesity. Never start a new diet without first talking to your doctor.