From changing habits to drugs and surgery: alternatives to treat obesity, explained by specialists

"If you look closely, there are no obese old people."

With this lapidary phrase, the president of the Argentine Society of Obesity Surgery and Metabolic Disease (SACO), Jorge Harraca, tries to raise awareness not only about the implications of obesity on health in general, but also regarding to another, even more worrying fact: the

of people with obesity can be reduced by up to 20 years.

This was stated by the professional in "Radiography of morbid obesity in South America", a meeting for journalists from different Latin American countries in which epidemiological data was disseminated, factors that affect the progress and treatments of this multi-causal disease, precisely in eve of

What are the most effective ways to treat it?

Why is its approach so difficult?

In which cases should medications be incorporated, and when is bariatric surgery indicated?

These are some of the concerns about which

spoke with referents on the subject in the country.

Healthy eating, the main measure to stop the advance of obesity.

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obesity in the country

It is not surprising that there is a date dedicated to raising awareness about this disease, whose prevalence is alarming: according to the fourth National Survey of Risk Factors (ENFR) of 2018, almost 7 out of 10 adults are overweight or obese

our country.

If we talk specifically about obesity, the figures show that

and 10% of children suffer from it.

These figures place our country in fifth place among the countries in the Americas with the highest rates of obesity in adults, after the United States, Mexico, Chile and Uruguay.

And the curve is growing.

In this sense, professionals seek to emphasize both the implications of this disease on health, as well as the

that generates it and the interdisciplinary nature of the treatment.

Obesity, a risk factor

There are many myths and false beliefs that surround this disease.

Although it is usually associated with weight, that is, the number of kilos, Harraca highlights the following: "It is not excess weight, it is

."

Meanwhile, Luciano Poggi, member of the board of directors of the Peruvian Association of Surgery and Metabolic Diseases (APCBEM), highlighted the "serious consequences" of 

, which impact the health and quality of life of patients, due to to its relationship with chronic conditions, such as diabetes, hypertension, heart disease, cerebrovascular accidents (ACV), fertility problems, different types of cancer, and even sudden death.

"In addition, people with obesity often experience

and suffer from social bias, prejudice and discrimination," he added.

On the other hand, in dialogue with

the nutritionist Mónica Katz pointed out that "it is very important to understand that obesity

, the person does not choose obesity, obesity is a chronic and relapsing disease, and it has to do with the environment that we all build as a society, as a culture".

When analyzing these causes that he defines as cultural, he mentions both sleep debt ("we sleep less than 7 hours thanks to technology"), certain drugs that increase weight, nutritional habits (which usually do not contain fiber, which

the microbiota and is associated with weight gain), as well as the presence of hormone disruptors.

"The person with obesity has no fault or responsibility, they have an environment that does not respond to transform this

," he stressed.

Physical exercise, another fundamental habit to prevent or treat obesity.

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Treatments for obesity

Now, how to approach a problem that has a multiplicity of causes?

The unanimous response of the specialists admits this complexity: the approach is

Change of habits

"The best way to treat obesity is with an interdisciplinary team, because the causes of obesity are multiple, it is not just about excess food, calories or poor quality food and a sedentary lifestyle; rather, an expert in nutrition, such as clinical management for the laboratory part and comorbidities of obesity, and also someone to manage the

part , in addition to stimulating physical activity," Katz stressed.

Juan Martín Romano, a nutrition specialist who promotes mindfulness applied to food, agrees: "There must be a promoting space that teaches how to build a

(including food education, physical exercise), a space for psychotherapy and cognitive restructuring ( emotional intelligence and tools for managing stress and anxiety), and pharmacological treatment of obesity when the case warrants it".

group meetings

The group can play an important role, according to Romano.

"Undoubtedly the approaches when they are in groups and the patients get in contact with other people in their same situation, with their same motivations for change, it is seen that the results

," he said.

Drugs

Another question is in which cases medications should be incorporated.

"When after at least three months of trying lifestyle changes (physical exercise, changes in eating pattern, shopping, management and emotions) cannot be achieved, it is time to improve behavior with drugs that work satiety," Katz said.

And he stressed that it is very important to see

in the person and help him with that, "with strategies or, if necessary, with remedies."

Surgery

Harraca affirms that it can be indicated based on the Body Mass Index, when it is

However, he adds that surgery can be used in cases in which it is considered that they have not been able to control the disease in a period of time certain.

Bariatric surgery is, according to the WHO, the most effective treatment against morbid obesity.

There are two types of interventions:

, through which the stomach and intestines are treated;

and the

, which reduces the size of the stomach.

Both require an exhaustive prior analysis.

In Argentina, almost 7 out of 10 adults are overweight.

Photo Shutterstock.

How to know what is the indicated treatment?

Changing habits, diets ranging from intermittent fasting to ketogenic, exercise plans, are some of the ways that are advertised to lose weight.

"To know what the indicated treatment is, the main thing is

: you recognize it because it first emphasizes going down quickly, not being hungry, which is a lie, because when the amount of what is ingested is lowered, it is It's normal to feel hungry. The issue is to slow it down, so that the hunger debt is not paid by the person with food, or with large portions," Katz said.

"What else does a magical diet promise? It usually sells a product or a service, it is rare that the recommendation is general 'do what you want'. It is common to say 'you have to buy this, you have to come with me'. Diets Magic generally sounds too good to be true. And you generally wouldn't give it to your 3-year-old or your 80-year-old mom."

For Romano it is essential to make an agreement with the person who asks for help.

"The heart of the intervention is that the patient evokes it

for her to want to make the change, and also to state what changes he is willing to carry out to get out of the lifestyle in which he finds himself. "

Regarding

the doctor affirms that he prefers to call it "digestive rest space".

As?

Making an earlier dinner than usual and having the first meal of the following day not before about 12 hours have passed, for example.

“

fasting to pregnant women, nor to patients who have an eating disorder, because many of them can misinterpret the benefits of fasting as just another fad diet, to end up bingeing later on,” he warned.

Katz disagrees with the fast.

are in fashion

: the ketogenic one, which proposes cutting out flour, and the intermittent fasting diet, for hours, whole days. Both forget the behavioral component of people, the eating pattern, the behavioral phenotype." raised.

In this sense, knowing what

each patient has in order to successfully guide treatment.

For that, there is a very simple scale called EFCA.

"In which the person or professional can know what type of behavior phenotype they have: if they are

, that is, if they eat for pleasure; if they are

, they eat a large amount in a short time; if they are

, they do not have a pattern of differentiated meals; if you are

, with emotional hunger, detail.

"The most important thing is to know that obesity

, it is a chronic, inflammatory disease that, if not treated, will have enormous consequences for the person, the family, and of course the health system: from cardiovascular disease, type diabetes 2, hepatic steatosis, sleep apnea, cancer, osteoarthritis, depression," he emphasized.

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