Most non-surgical weight loss programs are based on some combination of diet/behavior modification and regular exercise. Unfortunately, even the most effective interventions have proven to be effective for only a small percentage of patients. Research has shown that non-operative methods alone have not been effective in achieving significant long-term weight loss in severely obese adults(1).

In 2002, Australian researchers reviewed the effectiveness of treatments available for severe or 'morbid' obesity and concluded that surgery was the only effective option available at the time of the report(3).

Diet & Behaviour Modification

There are literally hundreds of weight loss diets available. Doctors who prescribe and supervise diets for their patients usually create a customized program with the goal of greatly restricting calorie intake while maintaining nutrition.

These diets fall into two basic categories:

Low-Calorie Diets (LCDs) are individually planned so that the patient takes in 500 to 1,000 fewer calories a day than he or she burns. Very-Low-Calorie Diets (VLCDs) typically limit caloric intake to 400 to 800 a day and feature high-protein, low-fat liquids. Studies show that the long-term results of Very-Low-Calorie Diets (VLCDs) vary widely, but weight regain is common(4).

Behavior modification uses therapy to help patients change their eating and exercise habits. Combining a Very-Low-Calorie Diet (VLCD) with behavior therapy and physical activity may help increase weight loss and slow weight regain. In the long term, however, Very-Low-Calorie Diets (VLCDs) are no more effective than more modest dietary restrictions(4).

If diet and behavior modifications have failed you and surgery is your next option, it is important to understand that diet and behavior modification will be instrumental to sustained weight loss after your surgery. The surgery itself is only a tool to get your body started losing weight - complying with diet and behavior modifications required by most surgeons would determine your ultimate success.

Exercise

Starting an exercise program can be especially intimidating for someone suffering from morbid obesity. Your health condition may make any level of physical exertion next to impossible. The benefits of exercise are clear, however. And there are ways to get started.

A 1997 National Health and Medical Research Council report concluded that exercise(5):

• alone without caloric restriction results in small amounts of weight loss 
• can protect against muscle loss during caloric restriction therapies 
• increases resting metabolic rates and reliance on fat oxidation at rest
• has beneficial effects on hypertension and cholesterol levels
• can help stabilise weight loss and maintain lower weight levels

It is important before increasing your physical activity levels that you consult a health care professional who can create an individual program appropriate to your individual circumstances.

The same National Health and Medical Research Council report recommended three considerations when increasing physical activity as part of a weight loss program(5):

• Close monitoring is essential to prevent muscular or skeletal injury
• Programs should be tailored to the individual, using activities that a person enjoys
• Continued dietary restraint (especially fatty foods) and education are critical to effective weight loss.

Over-the-counter & Prescription Medications

Over-the-counter (OTC) and prescription weight loss medications are available.

You should consult with your health care practitioner to determine the effectiveness and appropriateness of these medications as part of a weight loss program.