24 julho 2017


Diagnosing and Treating

Obesity has become epidemic proportions, with 300 million obese in the world, being considered a universal disease and one of the main public health problems of modern society. The risks posed by obesity are associated with chronic diseases, such as diabetes mellitus, dyslipidemia, cardiovascular diseases, coagulation disorders, degenerative joint diseases, neoplasias, sleep apnea, etc. Patients with severe obesity (called morbid obesity) have a 250% increase in mortality compared to non-obese patients.

The diagnosis must be etiological, qualitative, and quantitative. The quantitative diagnosis refers to the body mass or the mass of adipose tissue. In practice the calculation of the body mass index (BMI), which is the weight (in kilograms) divided by the square of the height (in meters), is still the most used. And the qualitative diagnosis refers to the distribution of body fat or the presence of visceral adiposity. When this fat is centralized it has a worse prognosis with regard to cardiovascular and metabolic diseases.

The treatment of obesity is not merely aesthetic, but its function is to reintegrate the obese into the active society. Initially, the treatment is dietary and behavioral, associated with a monitored physical activity. Often psychological counseling is needed, and the use of drugs as complementation. After a year of clinical treatment, if there are no favorable results or in the presence of comorbidities, treatment with gastric reduction surgery, called Bariatric Surgery, is indicated. Twelve months after this surgery, patients suffer an average weight loss of 40%, determining a large excess of skin in various areas of the body. The need for and indication of plastic surgery will depend on individual factors such as skin elasticity, age, fat distribution previously. The surgeries performed in these patients aim to increase their self-esteem, concluding the treatment without the stigmas of obesity.