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Obesity is associated with many health problems including cardiovascular disease, diabetes mellitus, gallstones and osteoarthritis. Factors that aggravate obesity may include depression, other psychological problems and some drugs.
The main treatment of the obese individual is a suitable diet, carefully explained to the individual, with appropriate support and encouragement; the individual should also be advised to increase physical activity.
Severe obesity should be managed in an appropriate setting by staff that have been trained in the management of obesity; the individual should receive advice on diet and lifestyle modification and be monitored for changes in weight as well as in blood pressure, blood lipids and other associated conditions. Drug therapy must only be offered as part of a package of care if there is demonstrated weight loss prior to treatment.
Phentermine and diethylpropion are central stimulants; they are not recommended for the treatment of obesity. Phentermine has been associated with a risk of pulmonary hypertension.
Sibutramine, dexfenfluramine, and fenfluramine have been withdrawn from the market because the benefit of treatment does not outweigh the risk of serious adverse effects.