Obesity: an increasingly frequent pathology

Written by: Dr. Javier Tébar Massó
Published: | Updated: 18/05/2018
Edited by: Top Doctors®

Obesity is an excessive accumulation of fat in adipose tissue that involves weight gain and morphotype changes with the appearance of metabolic and mechanical type complications.

To assess overweight and different degrees of obesity today is used the Body Mass Index (BMI), which is the result of dividing the weight in kilograms between the size in meters squared. A normal BMI ranges from 18.5 to 24.9. Grade I overweight is between 25 and 26.9; Grade II overweight between 27 and 29.9. Grade I obesity between 30 and 34.9; Grade II obesity between 35 and 39.9 and grade III or morbid obesity between 40 and 49.9. Finally, it is considered super-obesity when it exceeds 50.

Regarding the metabolic complications caused by obesity, the most frequent are type 2 diabetes mellitus, dyslipidemia and hypertension. Mechanics, osteoarthritis and venous insufficiency are the most important.

The influence of hormones on obesity

Hormonal alterations are frequent and multiple, and in turn can be cause or consequence. Obesity can be primary or secondary. Primary is the consequence of genetic mutations that induce obesity associated with environmental alterations, especially the sedentarism. Secondary obesity may be one of entry and among other things hormonal alterations such as excess corticosteroids, androgenic hormones, insulin, lack of thyroid hormones, hypogonadism, empty turkish chair, and so on.

Therefore the act of the specialist in Endocrinology before an obese begins with a detailed medical history that helps to know to what type of obesity the patient is, if it needs complementary explorations and of what type.

It is often observed that obese patients go to clinics where, because they are not supported by an endocrinologist, the existence of this pathology that may cause obesity is unknown.

Treatment for obesity

It must be assumed that there is no treatment that is 100% recommendable and / or effective. It depends on the degree of obesity and clinical phenomena around the obese person. Thus, for morbid obesity nowadays bariatric surgery is recommended, and within this the gastric BY PASS.

However, if a person does not want to operate, it is possible to resort to a treatment with diets very low in calories, is what was formerly called protein fast. These people will ingest between 600 and 800 calories a day, but not with typical foods, but with synthetic diets that offer the proteins, vitamins and minerals that the body needs daily. The adviser is that the patient is a month with these diets, then 15 days with a diet of 1200 calories "typically" balanced hypocaloric, to repeat this cycle as many times as necessary. With this treatment some patients have lost 100 kg in approximately 1 year.

Balanced low-calorie diets remain as useful as 40 years ago and a loss of 3 to 4 kilos per month means an average loss of 30 kg a year. Anyone who loses 30 kg or has solved their problem or improved it quite drastically. Remember that a loss of 10% of the weight is a great improvement at all levels.

The ideal drug to treat obesity would be the one that calms the appetite, which is the main problem, and that does not induce side effects. All of the above must be accompanied by an increase in physical exercise; With walking from one half to one hour a day may be sufficient because one has to look for more than the consumption of energy (which with exercise is much smaller than one thinks), promoting changes in pathophysiological alterations of the obese as resistance To insulin and its corresponding poor tolerance of sugars, all this improves with the loss of weight.

Treatment of appetite and satiety

With what most appetite is suppressed is with bariatric surgery, the loss of a hormone from the stomach, ghrelin, is its cause. With diet it is important to eat the total calories in 5 times, as well as having a water intake of 2 to 3 liters per day. Also chew well what you eat and do it slowly.

A drug that is a mixture of two others in the form of prolonged release has recently been marketed in Spain. Both substances are approved by the American FDA and the European Medicines Agency. But it has its contraindications and side effects. It should be strictly used by an expert physician, an endocrinologist. The most common adverse reactions are nausea or vomiting, constipation or diarrhea, headache, dizziness, insomnia and dry mouth.

Results and follow-up of treatment for obesity

The first days of starting an obesity treatment are hard for the patient, but more psychically than physically. The need to eat or "snack" can become unbearable in some people, so the doctor has to explain well to the patient what they will notice and the benefits that will be obtained.

The physician must give the means and teach them to use them, although the patient must use them. It's like when you stop smoking, the first 15 or 20 days are the worst, past these, things start to improve. At this stage the doctor should encourage the patient and demonstrate that their effort is being useful.

For the woman the best prize is, generally, to lower some sizes, the man seeks more the acquisition of a new energy that helps him in his day to day. But the two get many benefits in running their body.

*Translated with Google translator. We apologize for any imperfection

By Dr. Javier Tébar Massó
Endocrinology, Diabetes & Metabolism

Dr. Tébar Masso is an expert specializing in thyroid, neuroendocrine tumors, diseases such as diabetes and obesity, an expert on lipids and cardiovascular risks endocrinologist. The doctor is a great promoter, as has conducted multiple presentations at national and international conferences and has written over a hundred articles in professional journals. The endocrine Tébar Masso is also a great interest in research and has directed 13 doctoral theses throughout his career.

*Translated with Google translator. We apologize for any imperfection

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