Behavior Modification and Lifestyle Interventions

Behavioral modification in lifestyle programs has been an important part of programs for weight loss for more than a quarter of a century [27, 28]. Weight losses have been in the 5-10% range. Behavior modification has a number of components. First, it is a strategy designed to help people understand their eating behavior, from the triggers that start it to the location, speed, and type of eating, through the consequences of eating and the rewards that can change it. In addition, it consists of strategies to help people develop assertive behavior, learn cognitive techniques for handling their internal discussions, and ways of dealing with stress. The newest innovation in the use of lifestyle intervention is to implement it over the Internet. This has shown promising results [29].

Exercise

Exercise is important for maintaining weight loss, but when used alone does not generally produce much weight loss [30]. Comparisons of people who successfully maintain weight loss and those who do not show a critical role of exercise. More than 200 min/week provides greater likelihood of maintaining weight loss than lower levels of exercise. Using a pedometer allows counting of steps. Working toward 10,000 steps per day is a good goal.

Medications

The currently approved medications for the treatment of obesity are shown in Table 8.4. At present, five medications are approved for long-term treatment, and several others are approved for short-term use [2, 31].