The non-surgical, or medical treatments, for obesity although rarely successful are listed below:
Dieting - Traditional calorie restriction is associated with minimal success in achieving long term resolution of obesity. The weight loss is extremely modest and transient.
Exercise - Exercise in combination with or without calorie restriction is a preferred method of weight reduction.
Unfortunately, exercise of sufficient intensity to be effective is difficult in the obese.
Psychological - Hypnosis and psychological methods of altering eating habits have been proposed.
They are time and personnel intensive and offer little to change the habits of the population in general.
Medication - Drugs such as orlistat and sibutramine may be prescribed under medical supervision for the treatment of obesity.
The weight loss is modest (less than 5kg/yr) and transient. Almost all patients regain the lost weight on cessation of the medication.
In short, the success of weight loss programmes whether supervised or not, and the longevity of any weight loss is minimal.
The most agressive treatments of diabetes in patients with obesity will result in a modest reduction of the blood glucose, but has never succeeded in returning the patient to a non-diabetic state. Surgery cures almost every case of obesity related diabetes.
It is this dramatic improvement in the patient's health, beyond simply reducing body mass index figures which has driven surgery to be considered early in the treatment of patients with obesity related diabetes.
Whilst physicians may treat diabetes, surgeons can cure diabetes.