★ Spanish GPs are preparing a decalogue on obesity-related comorbidities and will promote research into social stigma in their consultations.

Within World Obesity Day this will be noted next time March 4therapists Diabetes, Obesity and Nutrition (DON) Group belonging Spanish Society of Internal Medicine (SEMI) We emphasize once again that in Spain there is an urgent need to recognize “obesity as a chronic and multifactorial disease”, while announcing the decalogue they have been working on to focus on Comorbid diseases associated with obesity in internal medicineand conducting research to understand and evaluate social stigma related to obese people in the field of internal medicine, which will be carried out at specialized consultations starting in May.

Dr. Juana Carretero, President of the Spanish Society of Internal Medicine (SEMI) remember that “you must not let’s talk about a metabolically healthy obese person. We must view obesity as a chronic, recurrent and multifaceted disease.textbook. Obesity is not a risk factor for diabetes and other metabolic and nonmetabolic diseases, but is itself a chronic disease that results in other metabolic diseases.

Obese people may develop metabolic diseases such as diabetes mellitus and metabolic liver dysfunction (MASLD), diseases cardiovascular disease (coronary artery disease, heart failure or stroke), sleep apnea, chronic kidney disease, up to 32 different types of cancer, infertility and infertility, and joint problems (osteoarthritis) and are at greater risk of needing prosthetics and replacement with some worn joints.

“We must change the discourse of the scientific community and help the public become more aware risk associated with obesity. Excess body fat is importantThis is a deterioration in health and quality of life, and it is not an aesthetic problem, but rather a health problem,” concludes Dr. Carretero, while emphasizing that society as a whole must “Stop blaming an obese person for being obese.”

In this sense, in relation to Stigma research which will be launched from the specialty indicates that “Stigma-related prejudices cause inequalities in many areas (family, work, health, education, etc.), which contribute to the loss of quality of life and increased health risks observed in people with obesity. And that this research will contribute to understanding and deepening the extent of stigma, its impact and implications for patients in internal medicine.

The prevalence of obesity among adults in Spain is 23%.but according to World Obesity Atlas 2023It is estimated to be 30% by 2030 and 37% by 2035. According to the OBEMI study, the prevalence of obesity (BMI>30) in consultations with internal doctors is 23.6%,

believe that if the global prevalence of obesity in Spain continues to rise as it is now, “it will continue to rise.” Added to this is the difficulty of identifying right to sarcopenic obesityalso widespread in internal medicine and which, even with a high body mass index, suggests a deficiency of muscle mass. “It is important to identify sarcopenic obesity in our patients because it is associated with less muscle mass, poorer muscle quality and more comorbidities.”emphasizes Dr. Carretero.

Regarding this type of obesity, Dr. Carretero explains that it can “appear in a variety of situations, just aging. This would be consistent with primary sarcopenia; for its part, secondary sarcopenia they might be for him fasting, both therapeutic and now associated with the worst economic conditions; due to the inactivity and sedentary lifestyle so prevalent in society; or associated with diseases, including type 2 diabetes and obesity“

Additionally, he acknowledges that “in our daily lives, in internal medicine consultations, sarcopenia is more common in people with type 2 diabetes, people with heart failure, atrial fibrillation or lung disease,” and reiterates that “The best approach to sarcopenic obesity is prevention.”

40% of obese people have this diagnosis), are undertreated (less than 20% receive evidence-based medications) and less than 1.3% of professionals prescribe these medications.

Decalogue “Obesity in internal medicine of the 21st century. “Construction of a decalogue of concomitant diseases associated with obesity in the treatment of internal diseases”which was prepared by Spanish therapists, contains 10 keys approximately obesity, patient phenotypes, obesity assessment, considerations pharmacokinetic and pharmacodynamic changes, cardiovascular benefits of weight loss, lifestyle, medications, surgery, sarcopenia and frailty-related aspects.

Among the main questions it is indicated that comorbidities in people with obesity are a consequence excess and location of obesity. And it explains that “weight loss of more than 10% leads to dramatic changes in health and cardiovascular health,” which “improves the management of comorbidities in people with obesity.”

Fountain: Spanish Society of Internal Medicine