Answer to Question 1
c
Answer to Question 2
The treatment of obesity is only moderately successful at the individual level, with somewhat greater long-term evidence for effectiveness in children and adolescents compared to adults. Treatment is usually organized in a series of steps from least intrusive to most intrusive depending on the extent of obesity. As you can see, the first step is usually a self-directed weight loss program in individuals who buy a popular diet book. The most usual result is that some individuals may lose some weight in the short term but almost always regain that weight. Furthermore, these books do little to change lifelong eating and exercise habits, and few individuals successfully achieve long-term results on these diets,
There is little evidence that physician counseling results in any changes. Nevertheless, physicians can play an important role by providing specific treatment recommendations, including referral to professionals.
The next step is commercial self-help programs such as Weight Watchers, Jenny Craig, and similar programs. These programs stand a better chance of achieving some success, at least compared to self-directed programs. Up to 80 percent of individuals, even if they are initially successful, are not successful in the long run. The most successful programs are professionally directed behavior modification programs, particularly if patients attend group maintenance sessions periodically in the year following initial weight reduction.
Finally, the surgical approach to extreme obesitycalled bariatric surgeryis an increasingly popular approach for individuals with a BMI of at least 40 . Approximately 15 percent of patients who have bariatric surgery fail to lose significant weight or regain lost weight after surgery. In the most common surgery, the stomach is stapled to create a small stomach pouch at the base of the esophagus, which severely limits food intake. Alternatively, a gastric bypass operation creates a bypass of the stomach, as the name implies, which limits not only food intake but also absorption of calories.