Long-term efficacy of medical treatments of obesity.

Obesity is a chronic, usually life-long condition. Therefore, the success of any treatment should be measured by the long-term weight loss. More patients lose weight than maintain the weight loss after the active phase of therapy has ended. Conservative approaches like dietary restrictions or behavior modification techniques have been only modestly successful in weight maintenance. Both are, therefore, suitable for patients with milder degrees of obesity. Anorexicants seem to have specific but limited use in the treatment of obesity. Fasting and protein sparing modified fast are indicated for patients with a high degree of obesity, i.e. for those who are at least 30% or 25 kg or more over their ideal body weight. Both these procedures have definite risks. Rapid weight loss is induced by fasting but long-term follow-ups showed gradual regain of weight loss. Combinations of various techniques such as behavior modification, exercise, proper nutritional instruction and protein-sparing modified fast seem to have the best chance for long-term success.