It is a complex disease, with a thousand faces and many causes. It has its roots in the psyche, but physiology has an equally important role. Obesity affects approximately 4 out of 10 children in Italy who are overweight or obese. In the adult group, however, 46 percent of the population carries around excess kilos, 10.2 percent are obese and in this last fraction one million six hundred thousand people would be seriously obese, with a BMI (the weight/weight ratio). height) greater than 35. Precisely due to its multifaceted nature, the management of this disease must necessarily be multidisciplinary, starting from prevention among children and adolescents, ending with the therapeutic strategies available today – these are interventions in the style of life, drugs or surgery.
Obesity: stigma, diagnosis and therapies
Obesity, stigma towards those with an abnormal body, but also diagnosis and treatment will be discussed on 13 October at the Festival di Salute in the round table entitled Stop Obesity, with interventions by Pier Luigi Bartolettideputy national secretary of the Italian Federation of General Practitioners (FIMMG), of Melania Manco professor of Pediatrics and Endocrinology at the Bambino Gesù Pediatric Hospital, and of Francesco TrottaDirector of the HTA and Pharmaceutical Economics Sector of AIFA.
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Identify cases
It is often up to the general practitioner, the first port of call for an obese or overweight patient, to identify the reasons for the disease by separating the genetic, metabolic and hormonal causes from those relating to lifestyle, incorrect eating habits, which in turn are perhaps linked to discomfort psychological that can have its roots in adolescence. The diagnosis is important because obesity is associated with an increased risk of some concomitant chronic pathologies: cardiovascular, respiratory, metabolic (such as type 2 diabetes mellitus), joint diseases. And oncological, because it is now clear that obesity constitutes a risk factor for cancer: according to the World Cancer Research Fund, 20-25% of cancer cases are attributable to the combination of excess weight and a sedentary lifestyle.
“Precisely as a complex and multifactorial disease – says Bartoletti – obesity must be treated with an overall approach, which takes into account all the available therapeutic options”. He understood the pharmacological path, where the new molecules represent not the end point but a piece of a multidisciplinary puzzle. In the Guidelines for the management of obese patients, it is recommended first of all to avoid stigmatization, to avoid losing contact with a patient who often already escapes the doctor’s control. “Obese people are often intercepted when they come to the office on behalf of others, perhaps to collect their wife’s prescription”, Bartoletti further explained.
The importance of dialogue
In this case it is important to hook them up thanks to a strategy based on patience, availability and dialogue. “We must always leave the door of hope open – added the FIMMG representative – letting pass the idea that obesity can be a transitory condition and not a definitive condemnation. And avoiding blaming the patient. “Stigma must be avoided especially in adolescence, a very delicate moment in the lives of girls and boys not only from a psychological but also physiological point of view – explained Manco – when pubertal development triggers a hormonal storm that affects the psychophysical balance and metabolism”.
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The effectiveness of drugs
When faced with a complex disease, it is necessary to be able to have various tools available in order to intervene in the most effective way possible. Nutrition and physical activity education come first, not only to prevent and treat obesity, but today the availability of drugs capable of helping you lose weight is changing the scenario of action. Molecules initially designed for diabetics, which today, thanks to the results of various clinical studies, are also indicated in the treatment of obesity.
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