Obesity: a epidemic in today's society. Analysis of the different types of treatment: motivational, pharmacological and surgical

Authors

  • Lucía Isabel Martínez Atienzar Grado Medicina Universidad Castilla la Mancha, España
  • Asunción Jiménez Espinosa Medico Familia. Gerencia Atención Integrada de Villarrobledo, España
  • Loreto Tarraga Marcos Enfermera Hospital Lozano Blesa de Zaragoza, España
  • Fátima Madrona Marcos Médico Residente Centro Salud Zona 5 A, España
  • Pedro Juan Tárraga López Profesor Medicina Castilla la Mancha, España

DOI:

https://doi.org/10.19230/jonnpr.3209

Keywords:

obesity, treatment, adipose tissue, cholesterol, triglycerides, comorbidity, cardiovascular disease, primary care, bariatric surgery, BMI, overweight, pharmacotherapy, weight loss, Roux-en-Y gastric bypass

Abstract

Introduction. Obesity is a frequent nutritional disorder, it constitutes a more serious public health  problem of the 21st century, due to its immediate and long-term consequences. The prevalence is  increasing alarmingly all over the world and at all ages, every time at an earlier age. Its treatment is  usually stepped with motivational therapy and associating pharmacological treatment; Finally, bariatric  surgery is performed in severe obesity and with risks to your health.

Objectives. Carry out an extended review on the different treatments to reduce weight in overweight or obese patients. Evaluate effectiveness and results.

Material and methods. It is a bibliographical review, with a search in different databases of health sciences and web pages, such as: Web of Science, Pubmed, Medline, WHO and Google Scholar. Analyzing  in a critical way the different studies carried out in recent years on the medical and surgical intervention of obesity.

Results. It requires early diagnosis, to avoid complications. Every patient should receive changes in their lifestyle such as diet and increased physical exercise. We have little therapeutic arsenal and many adverse  effects. Bariatric surgery is an effective treatment for obese patients or patients with comorbidities.

Discussion. Obesity requires an early diagnosis, to avoid later complications. Every patient should receive  changes in their lifestyle such as diet and increased physical exercise. We have little therapeutic arsenal  and the one we have has many adverse effects. Bariatric surgery is an effective treatment for obese  patients or patients with comorbidities.

 

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References

Albrink MJ, Meigs JW. The relationship between serum triglycerides and skinfold thickness in obese subjects. Ann NY Acad Sci 1965;13:673-83.

Berber A, Gómez-Santos R, Fanghanel G, Sanchez Reyes L. Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dyslipidaemia in a mexican population. Int J Obes Relat Metab Disord 2001;25:1794-9.

Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic síndrome among Us adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 2002;28:356-9.

Ponce-García I, Simarro-Rueda M, Carbayo-Herencia JA, Division-Garrote JA, Artigao-Ródenas LM, Botella- Romero F. 2015 Prognostic value of besity on both overall mortality and cardiovascular disease in the general population. PLoS ONE 2015.10:e0127369.

Campillo Álvarez JE. El mono obeso. La evolución humana y de las enfermedades de la opulencia: diabetes, hipertensión, arteriosclerosis. 5 ed Barceloan: Drakontos; 2010.

Friedman JM. Obesity in the new millenium. Nature 2000; 404:632-4

Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world a growing challenge. N Engl J Med. 2007;356:213-5.

Who. Diet, nutrition and the prevention of chronic diseases. Report of a joint FAO/WHO Expert consultation. WHO Technical report series 916. WHO: Genova; 2003

Ortega FB, Lavie CJ, Blair SN. Obesity and Cardiovascular Disease. Circ Res. 2016 May 27;118(11):1752-70.

Lobstein T, Baur L, Uauy R; IASO International Obesity Task Force. Obesity in children and young people: a crisis in public health. Obes Rev. 2004;5 Suppl 1:s4-s104.

Instituto Nacional de Estadística [Internet]. Madrid: Ministerio de Sanidad, y Política Social [actualizado el 21 de dicimebre 2016; citado agosto 2012]. Disponible en: http://www.ine.es/prensa/np582.pdf

Instituto Nacional de Estadística [Internet]. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad [actualizado el 14 de marzo 2017; citado 16 marzo 2017]. Disponible en: http://www.msc.es/estadEstudios/estadisticas/encuestaNacional/encuestaNac2011/NotaTecnica2011-12.pdf

Vliet-Ostaptchouk JV, Hofker MH, Schouw YT, Wijmenga C, Onland-Morent NC. Genetic variation in the hypotalamic pathways and this role on obesity. Obes Rev. 2009;10:593-603.

Salas-Salvadó J, Rubio MA, Barbany M, Moreno B; Grupo Colaborativo de la SEEDO. Consenso SEEDO 2007 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapeútica. RevEsp Obes 2007;5:135-75.

Allison DB, Kaprio J, Korkeila M, Konskeuvo M, Neale MC, Kayakawa K. The heredability of body mass index among an international simple of monozygotic twins reared apart. Int J Obes. 1996; 20:501-506

Gil A. Obesidad y genes. Vox Paediatrica 2002; 10:40-45

Medrano MJ, Cerrato E, Boix R, Delgado-Rodríguez M. Factores de riesgo cardiovascular en la población española: metaanálisis de estudios transversales. Med Clin (Barc) 2005; 124:606-12

Grau M, Elousa R, Cabrera A, Guembe MJ, Baena-Díez JM, Vega T, et al. Factores de riesgo cardiovascular en España en la primera década del siglo XXI: análisis agrupado con datos individuales de 11 estudios de base poblacional, estudio DARIOS. Rev Esp Cardiol 2011;64:295-304.

Gutiérrez-Fisac JL, Guallar-Castillón P, León-Muñçoz LM, Graciani A, Banegas JR, Rodríguez-Artalejo F. Prevalence of general and abdominal obesity in the adult population in Spain, 2008-2010: the ENRICA study. Obesity Reviews. 2012;13:388-92.

Encuesta Nacional de Salud [Internet]. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad [ATCUALIZADA 2016, CITADO AGOSTO 2016]. Disponible en : http://www.msssi.gob.es/estadEstudios/estadisticas/encuestaNacional/encuestaNac2006/EstilosVidaPorcentaje. pdf

Hernanz P, Peña A, Coca M, Suárez M. Prevalencia de obesidad central y obesidad por índice de masa corporal en un centro de atención primaria. Aten Primaria. 2005;35:103-4

Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Tchnical report series nº 894. Geneva WHO, 2000.

Rodríguez A, González B. El trasfondo económico de las intervenciones sanitarias en la prevención de la obesidad. Rev Esp Salud Pública. 2009;83:25-41

Pereira JL, García-Luna PP. Costes económicos de la obesidad. Rev Esp Obes 2005;3(1):1-12.

Aranceta-Bartrina J, Serra-Majem L, Foz-Sala M, Moreno-Esteban B; Grupo colaborativo SEEDO. Prevalencia de obesidad en España. Med Clin (bARC). 2005;125:40-6.

Dietz WH, Bellizzi MC. Introduction: the use of body mass index to assess obesity in children. Am J Clin Nutr. 1999;70:s123-s125.

Bhave S, Bavdekar A, Otiv M. IAP National task force for childhood prevention of adult diseases: childhood obesity. Indian Pediatr. 2004;41: 559-75

Bueno SM, Bueno LG, Moreno AL, Sarría CA, Bueno LO. Epidemiología de la obesidad infantil en los países desarrollados. En: Serra Majem L, Aranceta Bartrina J (eds.). Obesidad Infantil y juvenil. Estudio en Kid. Barcelona: Masson; 2001. p. 55-62.

Salvador J, Payeras F, Froján S, Frühbeck G. Obesidad. Concepto. Clasificación. Implicaciones fisiopatológicas. Complicaciones asociadas. Valoración clínica. Medicine. 2004;9:1167-1175.

Fisterra.com, Atención Primaria en la red [sede Web]. La Coruña: Fisterra.com; 2010 [acceso 2 agosto de 2016]. De Álamo A, González M. Obesidad. Disponible en: http://www.fisterra.com/fisterrae/guias.asp?idGuia=8

Weisberg S, McCann D, Desai M; Rosenbaum M, Leibel R, Ferrante A. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003;112:1796-1808. 46. Nadal JF. Obesidad intraabdominal y riesgo cardiometabólico. Aten Primaria 2008;40:199-204

Lobos JM, Royo-Bordonada MA, Brotóns C, Álvarez-Sala L, Armario P, Maiques A, et AL.; Comité Español Interdisciplinario para la Prevención Cardiovascular (CEIPC). Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación Española del CEIPC 2008. Rev Esp Salud Pública. 2008; 82:581-616.

International Diabetes Federation [Internet] Bélgica: IDF; [Creado en 2005; citado en 2005] The IDF consensus worlwide definition of the metabolic síndrome. Disponible en: http://www.id.org/webdata/docs/MetSyndrome

Who. Programme of Nutrition, Family and Reproductive Health. Obesity preventing and Managing the global epidemic. Report of a WHO consultation of Obesity. Génova, 3-5 June 1997. Génova: WHO;1998.

Morales A, Coca A. Obesidad, actividad física y riesgo cardiovascular: clasificación ergoantropométrica, variables farmacológicas, biomarcadores y “paradoja del obeso”. Med Clin (Barc).2010; 134:492-498.

Calle EE, Tun MJ, Petrelli JM, Rodríguez C heath C. Body-mass index and mortality in a prospective cohort of US adults. N Engl J Med. 1999;341:1097-1105.

Martínez JA, Moreno MJ, Marques LI, Martí A. Causas de la obesidad. Un Sist Sanit Navar. 2002; 25 Suppl 1: 17- 27. (foto)

Moreno GM. Definición y clasificación de la obesidad. Revista Médica Clínica Las Condes, 2012 – Elsevier Volume 23, Issue 2, March 2012, Pages 124-128.

The Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Esc Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J. 2011;32:2851-2906.

Summerbell CD, Ashton V, Campbell KJ, et al. Intervenciones para tratar la obesidad infantil (Revisión Cochrane traducida). En: Biblioteca Cochrane Plus, 2007 número 4. Oxford: Update Software Ltd. Disponible en www.update-software.com

Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L. Obesity in adulthood and its consequences for life expectancy: A life-table analysis Ann Intern Med 2003;15:196-233.

Griera JL, Contreras J. Síndrome metabólico: ¿fin de la controversia?. Rev Esp Obes. 2010;8;69-74.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al.; American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic sindrome: an American Heart Association/National Heart, Lung, and blood Institute Scientific Statement. Circulation. 2005;112:2735-52.

Balkau B, Charles M.A. Comment on the provisional report from the WHO consultation. European Group for the Study of Insuline Resistance (EGIR). Diabet Med. 1999;16:442-443.

Palma JL, Conget I, Bertomeu V, Ascaso JF, González JR, Alegría E; Grupo CLYDIA. prevalencia del síndrome metabólico en pacientes con enfermedad cardiovascular en España: estudio CLYDIA. Med Clin (Barc) 2007;128:407-13.

Brownell KD, ed The LEARN program for weight control. 7ª ed. Dallas. American Health Publishing, 1998: 12- 16.

Brownell KD, Rodin J. The weight maintenance survival guide. Dallas. Brownell & Hager, 1990:124-132.

Tárraga ML, Rosich N, Panisello JM, Gálvez A, Serrano JP, Rodríguez-Montes JA et al . Eficacia de las estrategias de motivación en el tratamiento del sobrepeso y obesidad. Nutr. Hosp. [Internet]. 2014 Oct [citado 2019 Abr 19] ; 30( 4 ): 741-748.

Barr SI, Yarker KV, Levy-Milner R, Chapman GE. Canadian dietitians’ views and practices regarding obesity and weight management. J Hum Nutr Diet. 2004; 17:503-12.

Bonfanti N, Fernández JM, Gomez-Delgado F, Pérez-Jiménez F. Efecto de dos dietas hipocalóricas y su combinación con ejercicio físico sobre la tasa metabólica basal y la composición corporal Nutr Hosp. 2014; 27(3):635-643.

Shaw K, O'Rourke P, Del Mar C, Kenardy J. Intervenciones psicológicas para el sobrepeso o la obesidad (Revisión Cochrane). http://www.update-software.com. The Cochrane Library, 2005 Issue 4.

Galicia I, Simal A. Tratamiento farmacológico de la obesidad. Sistema Nacional de Salud Vol.26-No 5-2002.

Solas M, Milagro FI, Martínez-Urbistondo D, Ramírez MJ, Martínez JA. Precision Obesity Treatments Including Pharmacogenetic and Nutrigenetic Approaches. Volume 37, Issue 7, July 2016, Pages 575-593 . https://doi.org/10.1016/j.tips.2016.04.008

Caixas A. Tratamiento farmacológico de la obesidad. Elsevier Vol. 47. Núm. 1.(Enero 2000)

Davidson MH, Hauptman J, DiGirolamo M, et al. Control de peso y reducción del factor de riesgo en sujetos obesos tratados durante 2 años con Orlistat : un ensayo controlado aleatorizado . Jama 1999; 281 (3): 235–242. doi: 10.1001 / JAMA.281.3.235)

Heck AM, Yanovski JA, Calis KA. Orlistat, a new lipase inhibitor for the management of obesity. Pharmatherapy 2000; 20:270-279.

Hill JO, Hauptman J, Anderson JW, et al. Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-year study. Am J Clin Nutr 1999; 69: 1108-1116.

Sjöstrom L, Rissanen A, Andersen T et al. Radomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. Lancet 1998; 352: 167-172.

Davidson MH, Hauptman J, DiGIrolamo M, et al. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA 1999;281:235-242. [Erratum, JAMA 1999; 281: 1174]. (el estudio que cojo)

Karhunen L, Franssila-Kallunki A, Rissanen P, Valve R, Kolehmainen M, Rissanen A and Uusitupa M. Effect of orlistat treatment on body composition and resting energy expenditure during a two-year weightreduction programme in obese Finns. Int J Obesity 2000; 24: 1567-1572.

Hollander PA, Elbein SC Hirsch IB, et al. Role of orlistat in the treatment of obese patients with type 2 diabetes: a l-year randomized double-blind study. Diabetes Care 1998; 21: 1288-1294.

Marín AC, Rodríguez JP. Estudio descriptivo de eventos adversos con orlistat reportados al programa Programa Mundial de Farmacovigilancia de UPPSALA 1994-2018. AAK. Química Farmacéutica. Ed 2018.

Sjöström L, Narbro K, Sjöström CD, et al (2007). «Effects of bariatric surgery on mortality in Swedish obese subjects». N. Engl. J. Med. 357 (8): 741-52. PMID 17715408. doi:10.1056/NEJMoa066254.

Andersen T, Backer OG, Stokholm KH, Quaade F. Randomized trial of diet and gastroplasty compared with diet alone in morbid obesity. N Engl J Med 1984; 310: 352-6.

Patterson EJ, Lubach OR, Swanstiön LL. A comparison of diet and exercise therapy versus laparoscopic Roux- enY gastric bypass surgery for morbid obesity. A decision analysis model. J Am Coll Surg 2003; 196: 379-84

Foley EF, Benotti PN, Borlase BC, Blackburn G. Impact of gastric restrictive surgery on hypertension in the morbidly obese. Am J Surg 1992; 163: 294-7

Pories WJ, Swanson MS, Macdonald KG, Long SB, Morris PG, Brown BM et al. Who would have thought it? An operation proven to be the most effective therapy for adultonset diabetes mellitus. Ann Surg 1995; 222: 339-52

Mac donald KG, Long SD, Swanson MS, Brown BM, Morris P, Dohm GL, Pories WJ. The gastric bypass operation reduce the progression and mortality of non-insulindepended diabetes mellitus. J Gastrointest Surg 1997; 1: 213-20.

Karlsson J, Sjöström L, Sullivan M. Swedish obese subjects (SOS). An intervention study of obesity. Two-year follow up of health-related quality of life (HRQL) and eating behaviour after gastric surgery for severe obesity. Int J Obes 1988; 22: 113-26

Torgerson JS, Sjöström L. The Swedish obese subjects (SOS) study: rationale and results. Inter J Obesity 2001; 25: 52-4.

Agren G, Narbro K, Jonsson E, Naslund I, Sjöström L, Peltonen M. Cost of in-patient case over 7 years among surgically and conventionally treated obese patients. Obes Res 2002;10:1276-1283.

Sjöström L, Luidroos AK, Peltonen M, Torgenson J, Bouchard C, Carlsson B et al. Lifestyle, diabetes and cardiovascular risk factor 10 years after bariatric surgery. N Engl J Med 2004; 351: 2683-93.

Christou NV, Sampalis JS, Liberman M, Cook D, Auger S, Mclean APH, Maclean LD. Surgery decreases longterm mortality, morbidity and Health care use in morbidly obese patients. Ann Surg 2004; 240: 416- 24.

Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrback K, Schoelles K. Bariatric surgery. A systematic review and meta-analysis. JAMA 2004; 292: 1724-37.

Ryden A, Torgerson JS. The Swedish obese subjects study: What has been accomplished to date? Surg Ob Rel Dis 2006; 2: 549-60.

Sjöström L, Narbro K, Sjöstróm D, Karason K, Larsson B, Wedel H et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741-52.

Benotti PN, Forse RA. The role of gastric surgery in the multidisciplinary management of severe obesity. Am J Surg 1995; 169: 361-7.

Martin LF, White S, Lindstrom W. Cost-benefit analysis of the treatment of severy obesity. World J Surg 1998; 22: 1008-17.

Buchwald H. Bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payer. J Am Coll Surg 2005; 200: 593- 604.

Flum DR, DIllinger ED. Impact of gastric bypass operation on survival: A populationbased analysis. J Am Coll Surg 2004; 199: 543-51.

Sowemino OA, Yood SM, Courtney J, Moore J, Huang M, Ress R et al. Natural history of morbid obesity without surgical intervention. Surg Obes Rel Dis 2007; 3: 73-7.

Dixon J. Survival advantage with bariatric surgery. Report from the 10th International Congress on Obesity. Surg Obes Rel Dis 2006; 2: 585-6.

Adams TD, Gress RE, Smith SC, Halmerson RCH, Simper SC, Rosamond WD ET AL. Long-term mortality after gastric bypass surgery. N Engl J Med 2007; 357: 753- 61.

Colquitt J, Clegg A, Sidhu M, Royle P. Surgery for morbid obesity. Cochrane Library Number CD003641, 2003.

North American Association for the study of obesity and the national heart, lung and blood institute. The practical guide: identification, evaluation and treatment of overweight and obesity in adults. NIH Publication 2000; 00:(4084).

Csendes J, Attila, Burdiles P, Patricio, Papapietro V, Karin, & Burgos L, Ana María. (2009). Review of the results of medical and surgical treatment of morbid obesity. Revista médica de Chile, 137(4), 559-566. https://dx.doi.org/10.4067/S0034-98872009000400016.

Gastrointestinal surgery for severe obesity: National Institute of Health Consensus Development Conference Statement. Am J Clin Nutr 1992;55:615S-9S.

Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg 2013;23:427-36. DOI: 10.1007/s11695-012-0864-0.

Christou N, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg 2006;244:734-40. DOI: 10.1097/01.sla.0000217592.04061.d5.

Sjöström L, Lindroos A, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683-93. DOI: 10.1056/NEJMoa035622.

Dhiren Patel, Pharmacotherapy for the management of obesity. 2015; 137 – 138.

Tran PT, Thomas A. Summary Minutes of the Endocrinologic and Metabolic Drugs Advisory Committee Meeting March 28–29, 2012. Disponible en: http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/EndocrinologicandM etabolicDrugsAdvisoryCommittee/UCM303352pdf. [Accessed Abril 3, 2019];

Rosenstock J, Klaff LJ, Schwartz S, et al. Effects of exenatide and lifestyle odification on body weight and glucose tolerance in obese subjects with and without prediabetes. Diabetes Care 2010; 33:11735.

Buse JB, Drucker DJ, Taylor KL, et al. DURATION- exenatide once weekly produces sustained glycemic control and weight loss over 52 weeks. Diabetes Care 2010; 33: 1255-61.

DeFronzo RA, Ratner RE, Han J, Kim DD, Fineman MS, Baron AD. Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2. Diabetes Care 2005; 28: 1092-1100.

Ryan T. Hurt & Jithinraj Edakkanambeth Varayil & Jon O. Ebbert New Pharmacological Treatments for the Management of Obesity 2014; 16:394

George A. Bray, MD, MACP, MACE, Boyd Professor; Medical treatment of obesity: The past, the present and the future 2014; 665-684

Ashish Kumar Kakkar, Neha Dahiya, Drug treatment of obesity: Current status and future prospects. 2015: 89–94

Moreno BE, Gargallo MA, Alvarez J, López de la Torre M Obesidad tratado de endocrinología básica y clínica. vol II Síntesis. 2000: 1730-62

Friedman jm, Halaas Jl, Leptina and the regulation of body weight in mammals. Nature. 1998; 395: 763-70.

Cannon B, Nedergaard J. Brown adipose tissue: function and physiological significance.

Physiol Rev. 2004; 84(1):277---359 Garvey WT. New tools for weight loss therapy enable a more robust medical model for obesity treatment: rationale for a complications-centric approach. EndocrPract 2013; 19: 864- 74

Colman E. Food and Drug Administration's Obesity Drug Guidance Document: a short history. Circulation 2012; 125: 2156-64

Published

2019-09-30