Obesity Treatment: Your Therapeutic Options Explained Simply
You might feel overwhelmed by the complexity of obesity treatments available today. Between the new medications everyone is talking about, surgical approaches, and more traditional methods, it’s not always easy to navigate. Rest assured: we will review your therapeutic options together, clearly and without judgment.
According to the WHO, obesity now affects over 650 million adults worldwide, and France is not spared, with approximately 17% of the adult population affected. Faced with this reality, medicine has evolved considerably in recent years, offering increasingly effective and personalized solutions.
The Revolutionary New Drugs: GLP-1 Agonists
You’ve probably heard of them: Ozempic, Mounjaro, Wegovy… These names are circulating widely, sometimes with contradictory information. Let’s clarify things together.
These medications belong to a family called GLP-1 agonists. Simply put, they mimic a hormone naturally produced by your gut after meals. This hormone sends a signal to your brain: « I’m full, I can stop eating ». It also slows down stomach emptying, helping you feel satiated for longer.
Semaglutide (Ozempic for diabetes, Wegovy for obesity) and tirzepatide (Mounjaro) are the two most promising molecules. A recent study published in the New England Journal of Medicine in 2024 shows that patients treated with tirzepatide can lose up to 22.5% of their initial body weight over 72 weeks.
These medications are administered by subcutaneous injection, usually once a week. I know this can seem intimidating at first, but most of my patients tell me they get used to it quickly. The pens are designed to be easy to use, with very fine needles.
Important: These treatments are not miracle solutions. They work best when accompanied by regular medical follow-up and an adapted lifestyle. Your doctor will assess if you are a candidate based on specific criteria (BMI greater than 30, or greater than 27 with comorbidities).
Bariatric Surgery: When and Why?
Obesity surgery remains a major option, particularly for severe obesity. Don’t worry: contrary to popular belief, it’s not an « easy way out ». It is a medical treatment in its own right, with precise indications.
According to the recommendations of the French National Authority for Health (HAS), updated in 2024, bariatric surgery is offered when:
- Your BMI is greater than 40 kg/m²
- Or greater than 35 kg/m² with complications (diabetes, hypertension, sleep apnea…)
- And after failure of well-conducted medical treatment for at least one year
Techniques have evolved significantly. Gastric bypass and sleeve gastrectomy remain the reference procedures. Sleeve gastrectomy, which involves removing a portion of the stomach to reduce its size, now accounts for approximately 60% of procedures in France.
What’s reassuring is that these procedures are now often performed laparoscopically, with small incisions. Recovery is generally faster than before. But be aware: surgery requires lifelong follow-up and significant dietary changes.
A European study from 2024 shows that 85% of operated patients maintain significant weight loss at 10 years, with a substantial improvement in their comorbidities.
The Nutritional and Behavioral Approach: The Foundation of All Treatment
Whether it’s medication or surgery, nutritional support remains fundamental. You might be asking yourself: « If I need medication or surgery, doesn’t that mean diet alone isn’t enough? »
You’re right, but the modern nutritional approach has nothing to do with traditional « diets ». It’s more about:
- Understanding your hunger and satiety mechanisms: sometimes, these are disrupted by hormonal or genetic factors
- Identifying your food triggers: stress, emotions, social habits
- Learning to eat mindfully: taking your time, savoring, listening to your sensations
- Adapting your diet to your lifestyle: no unrealistic constraints
Support from a dietitian specializing in obesity is now an integral part of the care pathway. Since 2024, certain dietary consultations may be reimbursed as part of the obesity care pathway.
Psychological support should also not be overlooked. Obesity is often accompanied by psychological distress, and it is not uncommon for eating disorders to be present. A specialized psychologist can help you identify and address these aspects.
Adapted Physical Activity: Move According to Your Abilities
« You need to exercise »: you’ve probably heard this phrase a thousand times. But concretely, when you suffer from obesity, how do you go about it?
The good news is that recommendations have evolved. You’re no longer asked to run a marathon! The goal is to move regularly, according to your abilities.
Start small: 10 minutes of walking a day is already an excellent start. Increase gradually. The ideal is to reach 150 minutes of moderate activity per week, but every minute counts.
If you have weight-related joint pain, prioritize:
- Walking in a pool or aqua aerobics
- Cycling or stationary bike
- Seated strength training exercises
- Nordic walking
Since 2023, Adapted Physical Activities (APA) can be prescribed by your doctor and are sometimes covered. Ask your general practitioner for more information.
How to Choose the Right Treatment for You?
Faced with all these options, you’re probably asking yourself: « Where do I start? » It’s normal to feel a bit lost.
The choice of treatment depends on several factors:
- Your BMI and comorbidities
- Your medical history
- Your personal preferences and constraints
- Your response to previous treatments
The modern approach prioritizes personalized and progressive care. Often, it begins with nutritional support and adapted physical activity. If necessary, medication is added. Surgery generally remains an option for more severe cases.
What matters is having a team to support you: your general practitioner, an obesity specialist (endocrinologist or nutritionist), a dietitian, and if needed, a psychologist and an adapted physical activity coach.
One important thing to remember: obesity is a chronic disease. This means that treatment is long-term, with regular adjustments based on your progress.
Towards Personalized Obesity Treatment
As you will have understood, treating obesity today is much more than « eating less and moving more ». It’s a global, personalized approach that takes into account your unique situation.
Recent advances, particularly with GLP-1 agonists, open up exciting prospects. But remember: the best treatment is the one that suits you, that you can follow long-term, and that respects your lifestyle.
If you recognize yourself in this article, don’t hesitate to talk to your general practitioner. They can guide you towards the appropriate specialists and help you build your personalized care pathway. You are not alone in this process, and effective solutions exist.
The important thing is to take the first step. Your health and well-being deserve it.