The obesity is excess body fat and overweight is a stage prior to ithighlighted Prof. Dr. Elvio Bueno, coordinator of the Assistance Unit of the Department of Endocrinology and Metabolism of the FCMUNA and its Hospital de Clínicas. In both cases the weight is greater than what is considered normal for the height of the person who has those kilos.
He warned that a patient who is so alone a little overweight can present many complications such as diabetes, high triglycerides, hypertension, due to the genetic load in the response to excess adiposity. Likewise, he said that there are obese people, who are 1.60 meters tall and 120 kilos, but they have nothing in the laboratory.
He stated that once one reaches a point of being overweight or obese treatment cannot be temporary. This is because every time one tries to lose weight, due to a neuroendocrine response, one tends to enter a plateau, after 10 to 15 percent of weight loss, it tends to rise again, so one never stops. you can neglect the treatment you started.
Dr. Elvio Bueno stated that the treatment basically has three equal parts. The most important part corresponds to the nutritionalwhich may or may not go at any given time helped by drugs that help overcome that plateau, which the neuroendocrine system generates when losing weight.
There are some patients in whom the magnitude of overweight and obesity generate additional metabolic disorders as severe or the same obesity is so severeto. Furthermore, taking into account that treatment with medication and drugs has a performance ceiling that goes around 15% and a maximum of 20 percent loss of body weight, which for a person who is 95 kg and 1, 60 tall is fine.
“It’s fine in the sense that if you go down to 180 to 150 pounds, you’re still going to be above your weight for your height, but it can help you solve a lot of your clinical problems. There are people who weigh 130, 140, 150 kilos, who will not have all their problems resolved and will continue to have joint problems, gastroesophageal reflux, sleep apnea, difficulties to move around and for quality of life it is not enough to lower that, then bariatric surgery is an even primary option for that patient”, he highlighted.
There are also patients who have diabetes who have already had some cardiovascular problem, who have very high cholesterol and triglycerides, who have tried several times to lose weight, but despite the fact that they had already been given drugs were unable to sustain a reasonable weight loss. He explained that, in these cases, even if they do not have an excessive body mass index, these patients can benefit from bariatric surgery if they have many chronic diseases and are at high risk of having cardiovascular health problems.
He affirmed that the bariatric is the one that offers the most the possibility of losing weight and that it helps to sustain the loss for a longer time, much more than the treatments that focus only on diet and medication.
Importance of portions
Prof. Dr. Elvio Bueno pointed out that in the long run nutritional treatment has to do with portion control. He explained that one can follow a vegetarian, vegan, hyperproteic diet, it can have the composition of macronutrients that one likes best, but in the long run what really matters is the Reduce portions for weight loss.
He commented that when one loses weight, the neuroendocrine system cancels the ability to satiate oneself. So beyond the style of the diet, when there is weight loss, he begins to eat more, pointing out as an example that, Even if you eat a lot of fruit instead of croissants, you will still gain weight if you overdo it.so here some drugs can help you to keep portions at bay.
He stressed that outside of a nutritional plan it makes no sense to start taking medications to control anxiety or hunger. He added that the size of the portions and the frequency of the portions and the overall amount of what one eats is very important.
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He said a good way to lose weight is to completely change your eating structure; that is to say, Instead of eating Milanese with mashed potatoes, one can opt for a grill with salad.. However, he urged even measuring the amount of salad one eats, for which he said it is important in the process to get used to leaving the plate full and overflowing with salad, for one in which meat is already on the side.
He pointed out that there are currently several places that offer apparently healthy or non-caloric meals, but that in reality those of the type Cesar tend to have an exaggeration of seasonings and result in excess calories. He added that they usually have croutons that are nothing more than chopped and fried bread, or breaded chicken Milanese type, as well as condiments such as sauces, for which he recommended prefer a mixed salad to which you can add olive oil in the necessary quantity, vinegar or lemon, accompanied by a portion of lean meat.
He commented that society stigmatizes people with obesity and overweight, because people in general consider that it is a problem related to the will of the patient. “He is considered lazy, a person who does not have the ability to control his impulse to eat of his own free will. This is not the case, the person who wants to have obesity does not have obesity, but the person who can have it, because first there are genetic factors, the tendency to obesity is in their genes, they can inherit it from their parents ”, he affirmed.
Attention in the Unit
The Care Unit of the Department of Endocrinology and Metabolism of the FCMUNA and its Hospital de Clínicas care for people who have an obesity or body mass index of 35 kg m2 or more, because otherwise they will not be able to cope. To schedule in person, you must go to the fourth floor of the hospital building, where the Department secretary is, or virtually by writing to WhatsApp at 0983 617833, in both cases from Monday to Friday from 8:00 a.m. to 11:00 a.m.: 00, only from 01 to 10 of each month.
Dr. Bueno pointed out that the Unit’s endocrinologist is the one who makes the initial evaluation and makes the indication. “The management of obesity is broad. It is the endocrinologist who makes the decision as to where to send the patient first and then everyone needs a mental health consultation with a psychologist, who does an office here, and nutritionists who take charge of prescribing the patients’ diets,” he said. he.
