Obesity: Treatments, Conceptualizations, and Future Directions for a Growing Problem

SIMPLE SUMMARY: The pyramid of interventions in the management of obesity include, diet restriction, diet therapy, physical exercise, anti-obesity drugs, prebiotics, probiotics, bariatric surgery, and cognitive behavioral strategies. Behavioral strategies that are being applied by predominantly private medical groups focusing on psychological assessments is appreciable; however, they are not replicated by all medical establishments, especially non-private health care institutions. This multifaceted disease has many treatment options; however, these options are not being fully implemented, especially in poor areas globally. Despite the upsurge in the market and expenditures in anti-obesity treatments currently available in economically stable areas of the world, obesity is still increasing at epidemic levels. The aim of this paper is to briefly highlight the anti-obesity treatments used presently and their inefficiency in isolation as individual treatments for obesity due to multifactorial causes. This report emphasizes that even focusing on psychological screening may not be enough to control this epidemic without further government and community cooperation. This report also presents novel strategies and radical thinking to include and amend successful interventions. Furthermore, we present details for incorporating web-based counseling and artificial intelligence to make treatments feasible, accessible, and cost-effective for all populations. We hope this paper will stimulate further debate and increase awareness in relation to the obesity problem and treatment strategies. ABSTRACT: Interventions in obesity management include nutritional selection, diet restriction, and physical exercise, followed by cognitive behavioral strategies, pharmacology, and surgery towards the tapered treatment end of the obesity pyramid of interventions. Calorie restriction, regular exercise, and several weight reducing drugs, including probiotic and prebiotic use, are increasing in the market as potential anti-obesity treatments all over the world. Despite these efforts, obesity is increasing and is at epidemic levels. We propose here that there should be a multicomponent individual specific treatment approach for treating this multifactorial pathogenesis, incorporating psychological assessment as a first step that may help to reduce the prevalence of this alarming epidemic. We also believe that focusing on psychological screening may not be enough to control this epidemic without government and community cooperation and intervention. Additionally, we suggest that it is imperative to take advantage of the developments in web-based counseling and artificial intelligence expansion in combination with available anti-obesity treatments to make treatments feasible, accessible, and cost-effective for populations of all ages. The purpose of this paper is to increase awareness and stimulate debate in relation to this growing problem.