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Ask the Medical Expert Archives 2000-2004

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Obese Mother
October 2000

Q. My mother is extremely obese. We have tried every possible way to convince her to lose weight. She does agree and tries different weight loss plans, but she does not have the will power to continue. I saw her recently and she is to the point that even breathing is hard for her. What can we do to convince her? What medical options are recommended. Something must be done before we lose her.

A. You are right to be concerned as obesity puts a high stress on the heart and blood vessels, and also increases the risk for diabetes. A trip to the supermarket will quickly remind you how common weight problems are in our society.

There is still much we don't know about weight control in humans. For example, a physical exam and extensive lab tests will rarely uncover anything we can identify and treat as the cause of the obesity. Low thyroid is occasionally found, but the majority of overweight people have normal thyroid function. There are some animal models now that show inherited factors leading to weight gain, but whether these will lead to treatment in humans is unknown.

The few medications available do not have established track records for effectiveness and safety. In addition, they are expensive, often not paid for by insurance, and tend to have side effects that are undesirable. Perhaps the human genome project will lead to new information, but that won't be known for some time.

In the meantime, the basic treatment remains changing the balance between energy taken in (food), and energy used (exercise). Even small amounts of exercise for starters can be helpful; your Mom should be walking every day and gradually build up the time and effort level. It often helps if she and a friend can start together.

A number of commercial weight loss programs exist and these can be very helpful by providing solid nutritional information, diet plans to follow, and encouragement for success.

HELPFUL WEBSITES:

http://www.obesity.org/

http://www.niddk.nih.gov/health/nutrit/nutrit.htm

MEDICAL REFERENCES (usually available through the library of your local hospital):

Berke EM, Morden NE. Medical management of obesity. Am Fam Physician. 2000 Jul 15;62(2):419-26.

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