Nonsurgical treatments include caloric restriction, exercise, behaviour modification, and drug therapy.
The long-term results of caloric restriction programs have been poor.
Exercise programs without some type of caloric restriction are generally ineffective beyond the loss of 6 to 10 pounds.
Long-term success with behaviour modification programs is also lacking.
Pharmacologic programs are popular, but they are equally ineffective as a treatment for morbid obesity; they use appetite-suppressing medications that act by increasing the central nervous system concentration of serotonin, a mood-elevating neurotransmitter believed to be involved in eating disorders.
Amphetamines and newer potentially addictive sympathomimetic medications are also used without significant long-term success.
Other medications are available that reduce the absorption of fat through the inhibition of lipase.
