Definitions of Pre-Obese, Obesity, and Morbid Obesity

The Body Mass Index (BMI) is a widely used metric to classify individuals based on their body weight relative to height. The categories are defined as follows:

  • Pre-Obese: BMI of 25-29.9 kg/m²
  • Obesity: BMI of 30-39.9 kg/m²
  • Morbid Obesity: BMI of 40 kg/m² or higher

It is important to note that BMI thresholds can vary among different ethnic groups. For example, individuals of South Asian, Chinese, and Black African descent may have higher health risks at lower BMI thresholds compared to Caucasians. Therefore, adjustments in BMI ranges are sometimes recommended for these populations to account for the increased risk.

Health Consequences of Obesity

Obesity is associated with a multitude of health complications, including but not limited to:

  • Cardiovascular diseases such as hypertension, coronary artery disease, and stroke
  • Type 2 diabetes mellitus
  • Certain types of cancer, including breast, colon, and prostate cancer
  • Respiratory issues, including obstructive sleep apnoea and asthma
  • Musculoskeletal problems such as osteoarthritis
  • Gastrointestinal issues, including gastroesophageal reflux disease (GERD) and fatty liver disease
  • Mental health disorders, including depression and anxiety

Healthy Eating and Exercise

Dietary Changes

Healthy eating is the cornerstone of weight management. Key dietary changes include:

  • Reducing the intake of processed foods high in sugar, salt, and unhealthy fats
  • Increasing the consumption of fruits, vegetables, whole grains, and lean proteins
  • Monitoring portion sizes and avoiding overeating
  • Staying hydrated by drinking plenty of water
  • Limiting alcohol consumption

Exercise

Regular physical activity is essential for weight loss and overall health. Recommended exercise includes:

  • At least 150 minutes of moderate-intensity aerobic activity, such as brisk walking or cycling, per week
  • Muscle-strengthening activities on two or more days per week
  • Incorporating activities that improve flexibility and balance

Weight Management Organisations

Organisations such as Weight Watchers and Slimming World provide structured programmes that have been shown to be effective in aiding weight loss. These programmes offer:

  • Support from peers and trained leaders
  • Guidance on healthy eating and physical activity
  • Regular monitoring of progress
  • Educational resources and tools

Evidence suggests that participants in these programmes tend to achieve better weight loss outcomes compared to those who attempt to lose weight independently.

Therapeutic Options

For patients who have not achieved significant weight loss through lifestyle changes, therapeutic options may be considered. These include:

Acarbose

Acarbose is an alpha-glucosidase inhibitor that slows carbohydrate absorption in the gut, leading to lower postprandial blood glucose levels. It is primarily used in the management of diabetes but can aid in weight reduction as well.

Orlistat

Orlistat is a lipase inhibitor that reduces the absorption of dietary fat. It has been shown to promote modest weight loss and improve cholesterol levels.

GLP-1 Agonists (Ozempic, Mounjaro and Wegovey)

GLP-1 agonists, such as liraglutide and semaglutide, are incretin mimetics that enhance insulin secretion, inhibit glucagon release, and slow gastric emptying. These mechanisms collectively help reduce appetite and promote weight loss. Evidence indicates significant weight reduction and improvement in obesity-related comorbidities in patients treated with GLP-1 agonists.

Hessington Health's Approach

At Hessington Health, we evaluate each patient’s progress with lifestyle modifications and, when necessary, explore therapeutic options. Our comprehensive weight management programme includes:

  • Initial assessment and regular follow-ups by a GP with a specialist interest in weight management
  • Personalised weight loss plans including dietary and exercise recommendations
  • Guidance on joining weight management organisations
  • Consideration of pharmacological treatments when appropriate
  • A structured programme for initiating and monitoring GLP-1 agonist therapy, ensuring patient safety and effectiveness

We ensure that patients receiving GLP-1 agonists are closely monitored, with regular check-ins to track progress and manage any side effects. Our goal is to help patients achieve sustainable weight loss in the safest and most effective manner possible.