Obesity is a multicausal disease that it is consolidated against the sum of several factors, which affect individually or simultaneously and that, especially in times like this, of uncertainty, nerves, isolation and lack of routine, can be exponentially enhanced. This also is compounded by a culture that celebrates thinness as a social success and the constant pressure to adapt to it, as if it were a simple matter of will or to find the magic diet that makes it possible in the shortest time. More than ever, we must break with these myths and work for a true awareness of this problem, which already affects 6 out of 10 Argentines, according to the Ministry of Health.
Overweight and obesity arise from the interaction of a multiple genetic disorder and a clearly favorable environment that enhances an increase in intake and a reduction in energy expenditure by alarmingly decreasing spontaneous and programmed physical activity. It is important to make clear that it is a chronic disease and as such, its treatment cannot be under any point of view an impossible diet to sustain with a short duration and an end on the contrary, they require prolonged or even lifelong treatments, depending on the individual case.
There are factors such as the easy access and low cost of foods with a higher caloric content, rich in fats and sugars; the increase in the price of fruits and vegetables; the decrease in time to eat and the work stress that predisposes to fast food resolutions that do not contribute to nutrition but to momentarily satiate the appetite as it may. For its part, the increase in sedentary activities is added to the excessive use of cell phones, television, computers or video games and the loss of the habit of walking or doing a daily exercise.
Currently, the time we spend choosing and preparing food is decreasing. In addition, stress and an accelerated pace of life lead us to eat quickly and unconsciously, with the autopilot on, enjoying food less and less while eating more. Also, there is no doubt that emotions and mood influence the choice of what we eat. Eating, in most cases, generates a feeling of well-being and food becomes the easiest and most accessible refuge, especially at times like this. Being able to distinguish real hunger from eating due to anxiety, habit, boredom, sadness or joy is key.
The psychological factor of the disease also has a considerable incidence. Therefore it is important to abandon erroneous and simplistic thoughts that associate obesity with lack of will, weakness of character, laziness or excessive gluttony. Stigmatizing a person suffering from it in this way only adds feelings of guilt, leading them to take drastic measures or extreme diets that worsen their situation.
The purpose of the treatment is a lifestyle change that must be maintained forever, without an expiration date, so it should not be prohibitive or unsustainable. However, due to ignorance or despair, those who suffer from these problems can become chronic victims of magic diets that promise solutions and will be detrimental to their true recovery. This, together with all the metabolic alterations that occur in the renutricin syndrome, implies a high dropout rate and the recovery of the lost weight that, in most cases, ends up far exceeding the initial one.
A treatment for obesity must be comprehensive Because, being a disease, it has signs and symptoms that we must attend to and with which we must work focusedly to reduce them as much as possible or, in the best of scenarios, eliminate them completely. For example, being overweight in an obese patient is just one of the symptoms you may have. By losing weight, I am managing only that symptom, but it is essential to keep focusing on the rest.
Faced with this, we can identify key points for progress: achieving a sustained, gradual and possible physical activity for each patient; make a food plan tailored and appropriate to the particular situation of the individual (considering tastes, routines, accessibility) with the help of a nutritionist; manage emotions and change with a mental health professional. Obesity requires comprehensive treatment with the correct accompaniment and monitoring of all health agents involved in the complexity of this pathology.
A true treatment of obesity as a disease seeks to achieve, through reeducation and psycho-emotional support, a change in eating habits and an increase in daily physical activity and, with it, a moderate, possible and sustained weight loss from 5 and 10%. This stands in opposition to immediate diet culture and short-term success. This type of approach involves a great effort for the patient, mainly because he must get rid of the idea that he is fat only because of what he eats and that the solution is strict diet, perspire by doing exercise wrapped in plastic wrap (or exercise in fashion ) to lose calories as much as possible after weighing so much and nothing has changed.
Although the main focus should be on sustaining a healthy eating and physical activity plan, it is often necessary to consider complementing it with medical assistance and safe and effective drugs for the decrease and control of body weight. In Argentina, we have three drugs approved for use in obesity: Orlistat, Liraglutide and the recently approved combination of a new drug in tablets that combines Naltrexone and Bupropin, which is administered orally and operates on the two main centers that regulate the appetite simultaneously. In this way, it manages to improve the control of the intake, acting on satiety.
Just as obesity is multicausal, treatment must also contemplate and attend to multiple variables, where medical treatment is essential but it is not the only one. It is not a simple short-term diet, it is a commitment and a constant effortAlmost for life, which the patient must do consciously and at will, accompanied by a responsible work team tailored to their needs.
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