Extra pounds go unnoticed in the medical history of 40% of obese people
Obesity is a public health problem that not only continues, but continues to rise, with numbers more typical of a pandemic. In fact, it is assumed that More than half of adults and a third of children in our country are overweightAccording to the Carlos III Institute of Health and the Aesan company. And these numbers are predicted to rise.
Specifically, 21.6% of the Spanish population is obese According to the Nutrition Study of the Spanish Population (ENPE), it is a chronic, complex, multifactorial and relapsing disease. To understand how this disease is managed in the NHS, Obequidad Studywhich describes the treatment of obesity in Spain from the perspective of primary care, endocrinology and internal medicine physicians. The data presented at the 46th National Congress of the Spanish Society of Primary Care Physicians (Semergen) corresponds to the results of a survey of 131 family doctors from various autonomous communities.
Obequity, promoted by healthcare company Lilly, reflects that 40.1% of patients with a body mass index (BMI) ≥30 kg/m2 did not have a history of obesity.. “We’re trying to recognize the importance of coding obesity, just like we do for stroke, diabetes or heart attack,” explains Dr. Jose Manuel Fernandez-Garciaone of the study authors, a specialist in family and community medicine and coordinator of the SEMERGEN Nutrition working group.
According to respondents, More than 95% of people receiving care for obesity in primary care have associated complications.. Among them dyslipidemiawhich is detected in 54% of obese people, type 2 diabetes (52%), high blood pressure (49%), osteoarthritis (45%), cardiovascular diseases (37%), sleep apnea (34%), fatty liver disease associated with metabolic dysfunction by 34% and mental illness (31%).
Chronic pathology
Recognizing obesity as a chronic, obesity-based disease that underlies multiple diseases is essential to recognizing the importance of prevention and a comprehensive approach with effective, evidence-based long-term care. “People with obesity deserve access to comprehensive health care that includes, depending on each patient’s needs, lifestyle interventions such as nutrition, exercise and behavioral therapies, medications, or bariatric surgery,” says Dr. Dr. Miriam Rubio de SantosMedical Director of Diabetes and Obesity at Lilly. “And the performance A primary care specialist is needed to manage such a chronic condition.from prevention, diagnosis, treatment and follow-up.”
According to the Obequidad study, improving the functional capacity and quality of life of people with obesity and reducing the risk of cardiovascular complications were the main reasons for starting treatment in primary care. BMI level, psychological complications, pain and aesthetic reasons were also included among the reasons for starting treatment, although they were less significant.
Diagnosis of obesity
In Spain, there are specific guidelines for a comprehensive approach to the problem of obesity. 18.3% of respondents indicated that they did not use any clinical practice guidelines. “It’s good that the treatment of obesity is standardized; there are centers that do not have specialized departments for this disease. interdisciplinary interventions and have standardized recommendations for obesity control.like the GIRO guide, a more efficient approach is needed. This is a very complex disease with many aspects. One group of professionals will not achieve this; several people must achieve this. This is a challenge for the entire society,” says the author of the study.
Obequidad also notes that the use of complementary methods to assess body composition is low. The most frequently used diagnostic method complementary to BMI for diagnosis is waist circumference (79% of respondents), while Methods such as bioimpedance are still not widely used in medical centers (8%). On the other hand, the study also shows that 9% of professionals indicate that they do not use any additional methods.
The development of obesity involves many factors: genetics, age, gender, ethnicity, education, economic level, sedentary lifestyle, stress, sleep disorders, urban and socio-political environment, etc. The study shows that the majority of patients seek medical help for obesity due to an opportunistic diagnosis (44%) or at their own request (41%). The most common profile of primary care patients is women aged 40–64 years with stage I obesity.
Therapeutic interventions
Comprehensive treatment of obesity requires coordinated interdisciplinary intervention. In case of class III obesity, the study demonstrates more frequent use pharmacological and surgical treatmentaccording to 78% of participants, compared with obesity degrees I and II.
According to the majority of participants, changes in diet and nutrition and increasing physical activity were the most recommended interventions for people with the highest levels of obesity.