Recently there have been some major scientific breakthroughs in the treatment of obesity. Treatment is desperately needed as obesity increases ones risk of many other diseases.

Everyone is familiar with these; they include diabetes mellitus, heart disease, gout, osteoarthritis, gallbladder disease, and even cancer. Obese people do not live as long as non-obese people. Obesity also takes a great toll on a person's self esteem.

No one wants to be obese, but most that are simply can not seem to do anything about it. Obesity has been considered a personal weakness, but we now have evidence that it is a medical illness. It is genetic and probably can not be cured. Most people last only two weeks or less on a diet. Even the successful dieters usually gain their weight back within a short time.

The hypothalamus of the brain and other structures in the brain work to maintain your weight, sometimes called the "set point." This yo-yo effect is probably worse than no weight loss at all. It probably leads to an increased percentage of fat in the body. Fat is less metabolically active and this leads to even more weight gain. With each successive cycle, weight is regained faster and weight loss takes longer.

This sounds discouraging but there is good news. Obesity can be treated like other chronic medical illnesses, such as diabetes or hypertension, but it requires chronic treatment. I believe obesity is caused by a chemical imbalance in the brain that is inherited or results from the mutation of one or more genes. Scientists have discovered an obesity gene in humane chromosomes. It leads to food cravings and an under-active metabolism. The more the cravings are resisted, the stronger they become.

The new treatment starts with correcting the chemical imbalances. We now have drugs that increase brain levels of serotonin and dopamine. These seem to be a major factor in this disease. With these medications, food obsessions disappear and you can feel full throughout the day and be more analytical about your eating. Having corrected the chemical imbalance, food cravings and slow metabolism are corrected, and a healthy diet can be followed.

Two of the drugs available now are phentermine and meridia. They both affect the brain's neurotransmitters. Phentermine enhances dopamine and norepinephrine. This causes people to eat faster but eat less. Meridia acts on serotonin and plays a large role in reducing the feelings or agitation and deprivation that are associated with hunger.

Serotonin also controls how much we eat, and the body's desire for protein and carbohydrates. The medication will not let you overeat. You can lose weight without doing anything. It will all come naturally as a result of normalizing your body chemistry.

Simple behavior modification can then be implemented such as not buying high calorie and high fat foods, not eating out at fast food restaurants, eating slower, off a smaller plate, with smaller utensils. Drinking more water during the day. Only eating in one place in the house, etc.

Exercise is, of course, also important. Activity can be increased even if you do not have a lot of extra time to go to the gym. You can use the stairs instead of the elevator, walk instead of driving when possible, etc. If you have some extra time, then do something you enjoy exercising your muscles, like walking, dancing, bike riding, etc.

The key is that the treatment must be long term, probably life long. If the medication is stopped, the chemical imbalance will return and so will the food cravings. It is just as if you stop your blood pressure medicine, you blood pressure will again become elevated.

The new medications are not habit forming and work effectively over the long term. This is much different from the old appetite suppressants.

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