Obesity: a complex management

The treatment of obesity requires a multidisciplinary approach. If the doctor is the privileged interlocutor, psychological, physio ... are important in successful treatment. How do you care? What are the ways to fight against the overweight?



Multifactorial disease, obesity is treated on a case by case basis. Evaluation is complicated, the objectives must be realistic and treatment is often long. A care that requires the establishment of a trusting relationship between doctor and patient.

A thorough investigation

A support complexePoids, medical problems, family history, physical activity, lifestyle, eating habits, motivations ... are all topics discussed at the first appointment with the nutritionist. It first assesses the health of his patient. It will search for the presence or absence of complications related to obesity such as diabetes, hypertension, cardiovascular disease, joint problems or sleep apnea. He tries to reconstruct the patient's weight history through the establishment of the weight curve. In fact, she used to date the age at which weight gain occurred, to determine the events that have accompanied, to provide benchmarks on the circumstances that trigger obesity, attempts to analyze the weight loss and results. Still to assess the patient's diet. For this, the doctor asks him to track them for ten days while he eats in a food diary. This document assesses the calorie intake and to identify, through interrogation, possible eating disorders. Finally over everything that was said, the nutritional values the psychological profile of the patient and determine the real nature of its application for weight loss.

Losing weight is not the only objective

Contrary to popular opinion the weight loss is not the sole objective of treatment of obesity. It is first necessary to ensure weight stability, prevent the worsening of obesity and thereby alleviate the risk of complications and provide specific treatment for them (even though weight loss may contribute).

Obesity: why treat?

Obesity is not only an aesthetic problem! Many diseases are favored by excess weight: cancer, cardiovascular problems, diabetes ... and increase the risk of premature death. Overview ...



If obesity has become a social phenomenon, the excess pounds are primarily responsible for many health problems.

Bad for the heart

Obesity: why treat? Among the main consequences of obesity, it should be noted the repercussions on the cardiovascular system. Thus, blood pressure increases with weight. There are three times more hypertension in the obese. The risk of atherosclerosis are logically extended: the fat is deposited more easily on artery walls. This increases the risk of myocardial infarction, angina pectoris and thrombosis. Risks venous (DVT, pulmonary embolism ...) are also more numerous.

Besides that obese people often suffer from high cholesterol. But this excess is a factor which further increases cardiac risk.

Bad to the Bone

Being overweight has adverse effects on the skeleton. The weight imposed on the joints and accelerate wear (hip, knee, spine ...). The problems and arthritis are very common. They may require the fitting of prostheses (hip, knee). Hernia problems also appear, leading to sciatica and lumbago other.

Many respiratory

Another major problem associated with obesity during sleep apnea. This stops breathing several times a night (at least 10 seconds, recurring five times per hour of sleep at least). These apneas can be extremely serious. Indeed, if they are not treated, they can be serious consequences: initially the individual experiences fatigue, memory loss, headaches, but long term, poor oxygenation of the body will cause problems heart disease, hypertension and even heart attack risk.

Tell me what you eat ...

Do you know exactly what you eat? That is the question that will seek to elucidate your doctor if you have seen for weight problems. But mostly, we underestimate our contributions ... We decrypts methods to assess diet.



If a weight problem, it is essential to know what you eat. For it will initiate a system adapted or simply to correct errors nutrition.
We are all super liars! :-)

Tell me what you eat ... If you are asked what you ate in the day, you will naturally tend to lie! Because several studies have demonstrated, we underestimate our consumption. Most often, this is not at all aware. For example, we "forget" what we eat between meals. In fact, the more control inputs or more one tries to restrict, the more you underestimate what you swallow. Only protein intake rather well evaluated.

What you should know ...

For the physician, it is nevertheless essential to know quite precisely your eating behavior. To evaluate your profile, the specialist will go through three main points:

* The type of food you usually eat and those you prefer;
* The circumstances in which you eat;
* The existence or non-disordered eating behavior (nibbling, compulsions ...).

The methods to know the truth ...

To know exactly what you eat, the doctor uses several tools:

* The weekly diary: It's a chart to fill every day with all food consumed and circumstances. It will thus give an overview of your diet. The doctor can identify the content of your meals and detect possible problems. It is often used during the first consultation, then define the areas for improvement.

* The 24-hour recall: The doctor uses your memory! It will ask in detail what you ate the night before writing or orally. This helps in knowing whether you have implemented the recommendations and to identify remaining problems. It is used in monitoring.

The treatment of extreme obesity

Nothing miraculous in obesity. Because, unfortunately, losing weight requires much effort, whether eating a less calorie or practicing a sport. However, in some circumstances, medication or surgery can help.



Doctors and nutritionists are less likely to recommend large weight loss in obese than before, because they fear a yo-yo and return to stop treatment, even more weighty than that of departure. Moreover, failures are often the norm and very poorly tolerated psychologically.

Reasonable goals

Weight loss, however, appear necessary when the body mass index (the result of a calculation between your weight and size that can assess your body size) exceeds 30, a figure which corresponds to the definition of obesity in the adult by the World Health Organization, as complications can be occur.

It is the same for American specialists when the body mass index between 25 and 29.9. This indicates a simple overweight and not obese, but those extra pounds involve risks cardiovascular or abdominal adiposity.

The treatments are designed, not to become a model or even thinner, but more modestly to reach a weight to better maintain their health and stay there. The obese and try to lose 5-15% of their maximum weight. A psychological support they will always offered, even psychotherapy.

Drugs are a booster

The medication does not replace diet or exercise. But they can be prescribed for people whose BMI exceeds 30, or greater than 25, but which are also risk factors for cardiovascular disease. These drugs are therefore not useful for treating mild overweight. And all the obese are far from responding.

Obesity: What support?

Obesity is rising all over the world. It is responsible for many health problems. Therefore it is essential to take it over. Which methods of treatment?



Treatment is defined in terms of severity of the disease, its causes, its stage of development. Its success is based on a combination of several elements:

* Plan restrictive;
* Exercise;
* Psychological support
* Treatment of complications, regardless of the success of weight control.

Between restrictions and surgery

The restricted diet changes based on the responses obtained in terms of loss and weight stabilization. Often after 12-24 weeks the weight reaches a plateau. The resumption of weight, very common, must be prevented.
In cases of severe obesity has been resorted to surgery to remove a portion of adipose tissue. Treatment success depends largely on the quality of medical care and support of loved ones. It is the concern of many stakeholders:

* Obesity GP and paediatricians who are on the frontline for the balance of the disease and its initial management. They are also the first to provide HIV prevention, including surveillance of risk in children;
* Specialists in endocrinology and metabolism, gastroenterology and internal medicine;

Dieticians

* Psychiatrists and psychotherapists;
* Occupational physicians, doctors advice, medical schools that have a fundamental role in prevention.