An Interview with Dr S B Gupta on "Obesity Management"
Q1. In your clinical practice what is the incidence of obese patients approaching you for the treatment of obesity?
Ans. Approximately 3-4% of total cases in my day-to-day practice approach me for the treatment of obesity.
Q2. Do they come for the treatment of obesity or do you treat them for obesity when they come with associated co-morbid conditions?
Ans. Both. Some patients approach me directly for treatment of obesity, while in other cases we have to treat for obesity because of the associated co-morbid conditions.
Q3. Which are the parameters on which you generally assess these patients?
Ans. Besides recording the patient’s initial weight, we generally also assess BMI and co-morbid conditions before initiating treatment for obesity.
Q4. What are the modalities / any specific protocols you follow for the treatment of these patients?
Ans. An obese patient is generally advised specified diet and exercise for initial 3-6 months. If desired results are not achieved in the specified time, then the patient is put on anti-obesity drugs.
Q5. "Obesity is a silent killer" how do your patients perceive this?
Ans. Unfortunately most of patients are not aware of this fact. The information regarding the co morbid events associated with obesity needs wide publicity both for the health care professionals and the public.
Q6. What according to you is the role of sibutramine in the treatment of obesity?
Ans. In my opinion sibutramine is a good drug for the treatment of obesity and is quiet well tolerated. It complies with the realistic approach to reduce the total body weight by 10% or 2 BMI units. This reduction itself has shown dramatic improvement in cardiovascular risk factors.
Q7. How long do you ask a patient to take sibutramine?
Ans. Generally I recommend my patients to take sibutramine 6-12 months depending on the realistic goal for weight loss is achieved.
Q8. Do you set the realistic goal for these patients?
Ans. Yes, generally I set a goal for weight reduction for my patients. This depends on the initial weight and BMI of the patient and also co-morbid conditions associated with his /her obese state.
Q9. What is the success rate seen by you?
Ans. 60-70% of patients who are put on sibutramine and who also follow the diet and exercise regime stringently are able to loose 5- 10 Kg of weight in six months.
Q10. Can you give any specific examples?
Ans. One of my patients Mrs. PGD, a case of controlled hypertension and morbid obesity with BMI > 40, when put on sibutramine therapy along with diet and exercise. She lost almost 14 Kg of weight and her requirement of antihypertensive drugs almost came to half.
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