How is obesity treated?

Treatment combines lifestyle changes, behavioural support, medication and sometimes surgery. The goal is sustainable weight loss and reduced disease risk.

When can GLP-1 medications be used?

For BMI ≥30, or BMI ≥27 with weight-related conditions (e.g., diabetes, hypertension, sleep apnoea), after medical assessment.

What are the criteria for medical obesity treatment?

BMI ≥30, or BMI ≥27 with comorbidities + prior lifestyle attempts + medical suitability and risk assessment.

Which lifestyle changes are important during treatment?

Protein-rich meals, fibre, regular eating patterns, strength training, daily movement, good sleep and stress management.

How fast is it safe to lose weight?

Losing 1–4 kg per month is usually sustainable and reduces the risk of muscle loss. Faster weight loss can be medically safe under supervision but requires professional monitoring.

Why does weight loss plateau after a few months?

The body defends its previous weight by lowering metabolism and increasing hunger hormones. This is a normal biological plateau and not a sign of failure.

Is the “set point theory” real?

Yes, the body defends a certain weight through hormonal and metabolic mechanisms. GLP-1 can help lower this set point over time.

Obesity Treatment: GLP-1, Lifestyle and Medical Care

Obesity is a chronic and complex disease that affects hormonal balance, metabolism, fertility and long-term health. Research shows that obesity is not about a lack of discipline, but about biological mechanisms that affect hunger, satiety, energy expenditure and hormonal regulation. For this reason, medical assessment and structured treatment are recommended in the same way as for other chronic diseases.

Below is a summary of treatment principles based on international guidelines and research:

Lifestyle treatment – the foundation of all obesity treatment

Lifestyle changes are a central part of treatment and form the basis of every guideline.

Diet

Research shows that several dietary patterns can improve weight and metabolic factors. Common denominators are:

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higher intake of protein and fibre

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slow-release carbohydrates

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reduced intake of ultra-processed food

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regular meals

Structured dietary programmes can improve blood sugar regulation and insulin resistance.

Physical activity

Physical activity is important for health and contributes to:

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improved insulin sensitivity

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better blood pressure

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improved sleep

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reduced stress

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greater weight stability after weight loss

Behavioural support

Support from healthcare professionals or digital programmes can:

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strengthen motivation

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create sustainable routines

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reduce the risk of relapse

Medical Treatment: When Lifestyle Changes Are Not Enough

International guidelines state that medical treatment may be considered for individuals with:

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BMI ≥ 30

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BMI ≥ 27 with comorbidities (e.g., insulin resistance, PCOS, type 2 diabetes, sleep apnoea or high blood pressure)

In Sweden, all medications used for obesity treatment are prescription-only and require individual assessment by licensed healthcare professionals.

Medication Groups

There are currently several types of medications used in the treatment of overweight and obesity, including:

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medications that influence appetite regulation

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medications that improve insulin sensitivity

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medications that reduce energy absorption in the gut

Effect and suitability vary between individuals, and treatment must always be prescribed and monitored by healthcare professionals.

Surgical Treatment – for Severe Obesity or When Other Methods Are Insufficient

Bariatric surgery, such as gastric bypass or gastric sleeve, may be considered for individuals with very high BMI (≥ 40) or BMI ≥ 35 with comorbidities, and can be a possible option for certain individuals.

Obesity, Fertility and Pregnancy – Why Treatment Matters

Treatment of obesity may contribute to:

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improved ovulation

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increased chance of pregnancy

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reduced risk of gestational diabetes

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reduced risk of high blood pressure and preeclampsia

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improved outcomes in assisted reproduction

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reduced risk of complications during childbirth

Studies show that even moderate weight loss (5–10%) can improve hormonal balance and fertility.

Summary

Obesity is a chronic disease that requires long-term and individualised treatment. The most effective approach often consists of a combination of:

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lifestyle support

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medical assessment and, when appropriate, medication

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in some cases, surgery

Treatment can improve weight, hormonal balance, fertility, pregnancy outcomes and long-term health.

Sources

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Mechanisms of obesity as a chronic disease. Nature Reviews Endocrinology. PubMed

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Pharmacologic treatment of obesity: an Endocrine Society guideline. Journal of Clinical Endocrinology & Metabolism. PubMed

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GLP-1 receptor agonists for weight management: clinical evidence. Lancet Diabetes & Endocrinology. PubMed

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Bariatric surgery and long-term outcomes. JAMA.

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Obesity and fertility: impact on ovulation and pregnancy outcomes. Human Reproduction Update. PubMed

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PCOS, insulin resistance and metabolic dysfunction. Journal of Clinical Endocrinology & Metabolism. PubMed

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Weight loss and fertility improvement in women with PCOS. Human Reproduction. PubMed

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Treating Obesity: What You Need to Know