Friday, February 23, 2018

The treatment of Chronic Obesity is with multiple medications.

The treatment for Chronic obesity is multiple diet medications.
Seven simple steps.
ONE
Metformin should be started for pre-diabetics with fasting glucose greater than 95..
TWO
Liraglutide (Victoza) injection should be second drug for obese diabetic type 2.   The new oral  semaglutide will be good for those who don't want to take injections if it works and is tolerable)
THREE
Canagliflozin (Invokana) should then be added for further glucose control for type 2 Diabetes.
FOUR
Hopefully during this period the patient has been on LCHF (low carbohydrate high) or some form of Atkins diet or South Beach Diet.
Check that carbohydrates are low enough to cause nutritional ketosis with urine strips or blood sticks.
FIVE
To lose more weight and then maintain weight loss a patient will eventually need to be on either Qysemia, Contrave or Belviq for the rest of their lives.
SIX
Good news is people only need to walk 20 to 30 minutes a day or achieve 5,000 to  10,000 steps a day.  Exercise is for health not weight loss. 
SEVEN
Drink decaf coffee in morning so that afternoon hunger can be treated with a strong cup of regular coffee.

Insulin and Bariatric surgery should be reserved for those who fail the above and have morbid obesity


Update on my weight maintenance 7-14-19 link

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