Obesity

Obesitas · Obezita

What it is

Excess body fat that raises the risk of diabetes, heart disease, joint wear and some cancers; lost weight tends to return.

call 112 / 911 now Chest pain, or sudden breathlessness with a swollen calf
see a doctor soon Loud snoring with pauses in breathing and daytime sleepiness
see a doctor soon Great thirst, passing lots of urine or blurred vision
see a doctor soon Fast weight gain with swollen legs or breathlessness

GLP-1 and GIP agonists — 15–20% of body weight in trials, about two-thirds back within a year of stopping; nausea common, gallbladder disease and pancreatitis rare; semaglutide cut heart events from 8.0% to 6.5% in people with heart disease (SELECT); the trials are the makers' trials support
Orlistat — small effect, unpleasant mixed evidence
Bariatric surgery — the largest and most durable effect, with surgical risk and lifelong vitamins trials support
Structured programmes — a few kilos, kept only while the programme lasts mixed evidence
Fen-phen and sibutramine — sold for weight loss, withdrawn for heart-valve damage (1997) and heart attacks and strokes (2010) not confirmed in trials

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

Intermittent fasting — trials show weight loss similar to ordinary calorie restriction mixed evidence
Ketogenic and carnivore diets — faster early loss; after a year results are similar to other diets mixed evidence
Berberine — small trials, about 2 kg early / small studies
The hCG diet — trials show the loss comes from the 500-kcal diet, not the hormone not confirmed in trials