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In Polish society, there is still a belief that an obese person can easily deal with being overweight. This is a mistake. Obesity is a disease that must be treated throughout life. And diet and exercise alone are not enough.
- Obesity is a disease – it does not result from laziness or neglect of patients
- It is a damaging belief that must be fought against
- In the treatment of obesity, diets, exercise, and even medications are not effective enough
- More information can be found on the Onet homepage.
Obesity must be treated throughout life
Adequate nutrition and regular physical activity are essential, but they are best one step ahead in preventing obesity.
– Obesity is a chronic disease, without a tendency to spontaneously resolve, characterized by relapses. That is why it must be treated throughout life – emphasizes prof. Lucyna Ostrowska from the Department of Dietetics and Clinical Nutrition, Medical University of Bialystok.
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At the same time, specialists point out that in the treatment of obesity, the use of a slimming diet and an increased dose of exercise alone is usually very ineffective.
– The effect of non-pharmacological treatment in obese patients is usually 3-5%. loss of the initial body weight and it is often not maintained over time – says Prof. Paweł Bogdański from the Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics of the Medical University in Poznań.
Meanwhile, the effectiveness of weight reduction through pharmacological obesity treatment is estimated by experts at 3-10%, and thanks to new drugs that will be introduced to the EU market next year, it is expected to increase up to 15%. In this context, it is worth adding that, apart from the mere “weight loss” of patients, drugs used in the treatment of obesity are also aimed at preventing its various complications. Therefore, specialists regret the fact that in our reality, drug treatment of obesity is still not very popular and rarely used.
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According to the current standards, pharmacotherapy – in order to reduce body weight – can be used in people with a BMI over 30 kg / m2 or people with a BMI over 27 kg / m2 if they have complications related to obesity. As a rule, medications are used in conjunction with diet, exercise and psychological support.
Therefore, an adequate diet and an appropriate level of physical activity remain – invariably – one of the pillars of obesity therapy. However, in many cases, especially in advanced obesity disease, these basic methods of weight reduction often turn out to be simply insufficient.
If you have a problem with excess body weight, do the Full Nutrigenetic Profile – determination of metabolic predispositions. Thanks to it, you will learn about your genetic conditions, which will make it easier to start an appropriate diet and therapy also in the treatment of obesity.
How to heal yourself when diets and medications don’t work
However, the list of treatment options available today does not end with lifestyle changes and medication use.
Prof. Lucyna Ostrowska emphasizes that the most effective currently known method of treating advanced obesity is the so-called bariatric surgery, thanks to which an average of 7 to 38 percent is obtained. weight loss (depending on the method used). As part of the surgical treatment of obesity, various types of surgical procedures are used. radical reduction in gastric capacity.
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Dr hab. Łukasz Kaska from the Center for the Treatment of Obesity and Metabolic Diseases of the Medical University of Gdańsk emphasizes that another important effect of bariatric procedures is the removal of ghrelin glands, which is one of the strongest signals of hunger, along with a fragment of the stomach. Thanks to this, bariatric procedures significantly affect the patient’s metabolism and appetite, which helps in effectively shedding unnecessary kilograms.
But be careful! Surgical obesity treatment is not a medical procedure intended for universal use in all obese volunteers.
So who can apply for qualification for such a procedure in the light of current medical standards?
– Bariatric procedures should be considered in adults with a BMI above 40 kg / m2 if other treatments are not effective. It is not recommended to perform bariatric procedures in patients with BMI below 35 kg / m2 – informs prof. Lucyna Ostrowska.
In addition, in line with current guidelines, physicians may also consider bariatric surgery in adults with a BMI ≥ 35 kg / m2 who have other serious diseases or complications (e.g. type 2 diabetes) if they cannot be successfully performed. controlled with lifestyle changes and drug therapy. Each patient is individually qualified for surgery.
Facts and myths about bariatric surgery. How many people in Poland qualify for such an operation?
Dr hab. Łukasz Kaska estimates that there are several hundred thousand such people in our country. Meanwhile, so far, no more than 5 such procedures have been performed in Poland each year.
There are many reasons for this, not only on the part of the health care system.
– There are many myths and harmful stereotypes in our society regarding bariatric procedures, such as the fact that they are easy to deal with or that they kill, which means that they are extremely dangerous. Meanwhile, among others I, eight years after my surgery, can assure everyone that it was really worth it – says Katarzyna Partyka from the CHLO Bariatric Patients Association, which raise public awareness of bariatrics, that is, in practice, often also encourage people struggling with obesity to make a decision to perform such a procedure.
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Thanks to the surgery and the change in lifestyle introduced after it, Katarzyna Partyka lost almost 70 kg.
The main activity of the association is organizing support groups in various Polish cities for people after such treatments, which thanks to them motivate each other to further, persistent fight with the disease – in order to avoid relapse.
Although in practice, each surgical procedure is associated with a lower or greater risk, doctors agree that in the case of bariatric surgery, the benefits resulting from them far outweigh the risks, as evidenced by, inter alia, the fact that obese people who have undergone such surgeries live longer and have a much better quality of life than those who have not. Statistical data show that a higher risk of complications and higher perioperative mortality are commonly accepted surgical procedures such as laparoscopic excision of the gallbladder or hip arthroplasty.
After bariatric surgery, the treatment does not end, of course – the surgery is only an important stage. Anyway, the patient must also prepare properly for the operation itself, incl. by making some changes in your life, and also by taking the right medications. After the procedure, the patient remains in contact with specialists – it is best for the therapeutic team to consist of doctors of various specialties, as well as a dietitian, physiotherapist and psychologist (behavioral therapy). It is necessary to effectively and permanently change the habits that were conducive to the development of the disease. However, weight maintenance is then incomparably easier, and many people may discontinue their previous medications over time. For example, Katarzyna Partyka no longer needs to take hypertension pills.
New treatment options thanks to the sugar tax
This year, a pilot program of comprehensive specialist care for patients treated for morbid obesity (called KOS-BAR for short) is to start in Poland. Thanks to it, patients’ access to bariatric procedures reimbursed by the National Health Fund is to increase significantly.
Interestingly, this program will be implemented thanks to the so-called the sugar fee on sweetened beverages, thanks to which nearly PLN 300 million has already been allocated to the budget of the National Health Fund.
Details about this program can be found in the draft regulation of the Minister of Health related to it on the website of the Government Legislation Center (RCL).
One thing is for sure. This program is very much needed in Poland, as evidenced by the latest epidemiological data.
– Obesity in Poland is present in 15,4 percent. men and 15,2 percent. women, and morbid obesity (BMI 40 or more) in 0,5 percent. men and 0,4 percent. women – says Dr. Jerzy Gryglewicz from the Lazarski University, while emphasizing that obesity is associated with the occurrence of many dangerous and difficult to treat complications, such as type 2 diabetes, hypertension, ischemic heart disease, sleep apnea, osteoarthritis, depression or some cancers.
Let us recall that obesity I degree is diagnosed with BMI values of 30–34,9 kg / m2, second degree obesity at values 35–39,9 kg / m2, and grade III obesity from 40 kg / m2.
Wiktor Szczepaniak, Zdrowie.pap.pl
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