Obesity

Obesity, or nediez pimelose (technically, the Greek pimelē = ose fat and morbid process) is a chronic multifactorial, in which the natural reserve of fat increases to the point that becomes associated with certain health problems or increased mortality rate. It is the result of a positive energy balance, ie food intake is greater than energy expenditure.

Although it is an individual clinical condition, is seen increasingly as a serious and growing public health problem: excessive body weight predisposes to a number of diseases, particularly cardiovascular disease, type 2 diabetes mellitus, sleep apnea and osteoarthritis.

According to the IBGE, on research done in 2008 and 2009 in Brazil obesity affects 12.4% of men and 16.9% of women over 20 years, 4.0% of men and 5.9% of women aged 10 and 19 years and 16.6% of boys and 11.8% of girls aged 5-9 years.1 Obesity increased between 1989 and 1997 from 11% to 15% and remained fairly stable since being higher in southeastern country and lowest in the Northeast.

Treatment

The primary treatment for obesity is the reduction of body fat through diet adjustment and increasing exercise. Diet and exercise programs produce average loss of approximately 8% of the total mass (excluding those who do not complete programs). Not everyone is pleased with these results, but even the loss of 5% of the mass can contribute significantly to health. Harder than losing weight, maintaining weight is reduced. Between 85% and 95% of those who lose 10% or more of their body weight, regain all the lost weight within two to five years. The body has systems that maintain homeostasis in certain fixed points, including weight. There are six recommendations for the clinical treatment of obesity:

1. People with a BMI above 30 should begin a program of reduced caloric diet, exercise and other behavioral interventions and establish realistic goals for weight loss.

2. If the goals are not achieved, drug therapy can be offered. The patient should be informed of the possibility of side effects and the lack of data on safety and efficacy of these drugs in the long term.

3. Pharmaceutical therapy may include sibutramine, orlistat, phentermine, diethylpropion, fluoxetine and bupropion. For more severe cases of obesity, stronger drugs such as amphetamine and methamphetamine may be used selectively (only after consulting your doctor responsible).

4. Patients with BMI over 40 who do not reach their goals of weight loss (with or without medication) and who develop other conditions arising from obesity, may receive an indication to perform bariatric surgery. The patient should be informed of the risks and potential complications.

5. In these cases, surgery should be performed in centers that perform many of these procedures since the evidence indicates that patients of surgeons who perform frequently tend to have fewer complications after surgery.

Epidemiology

Obesity is also characterized as a matter of aesthetic and psychological nature, and is a major health risk. According to a study by WHO, currently about 500 million adults.

Nauru, the Pacific island has the highest obesity problems, because 80% of the population suffers from obesity, and the country where there is more malnutrition in Somalia, where 75.02% of the population goes hungry. Countries like Barbados, USA, Brazil also suffer from serious problems with a population overweight.

In the last twenty years, Latin America has gone through the epidemiological transition, demographic and nutrition, reflecting changes related to nutrition. In this population, such changes are well characterized by surveys that show the passage of the higher incidence of malnutrition for the greater prevalence of obesity. Gives to this phenomenon the name of Nutritional Transition 5.