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2001, Número 4

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Gac Med Mex 2001; 137 (4)


La obesidad en el Siglo XXI. Avances en la etiopatogenia y tratamiento.

Chiprut R, Castellanos-Urdaibay A, Sánchez-Hernández C, Martínez-García D, Elena-Cortez M, Chiprut R, Conde OP

Idioma: Español
Referencias bibliográficas: 53
Paginas: 323-334
Archivo PDF: 100.48 Kb.


RESUMEN

La obesidad es compleja en su etiología y tratamiento. Su incidencia global va en aumento. El promover la pérdida de peso sólo puede traer efectos benéficos. La obesidad es un trastorno crónico de origen multifactorial. El descubrimiento del gen ob y su producto, la proteína OB o Leptina, del neuropéptido Y, así como de las alteraciones del metabolismo de los tejidos lipogénicos que alteran el apetito, son avances significativos para comprender su etiopatogenia y tratamiento. Estos nuevos conocimientos cambiarán la filosofía del tratamiento de la obesidad. La obesidad responde mal al tratamiento no quirúrgico y su control debe ser a largo plazo a pesar de las considerables presiones sociales y biológicas que promueven la recuperación del peso perdido. El tratamiento del paciente obeso debe realizarse por un equipo multidisciplinario, debiendo incluir una dieta hipoenergética, un plan de ejercicios, modificaciones conductuales y, en varios casos, terapia familiar. Su manejo debe ser diseñado en forma individual para cada paciente. El uso de medicamentos en el tratamiento de la obesidad no debe ser un sustituto para la modificación de la dieta ni para la actividad física. La cirugía bariátrica está indicada sólo en aquellos pacientes cuyo IMC es mayor de 30 kg/m 2 . Los médicos y sus pacientes deben interactuar estrechamente, evaluando los riesgos posibles que implica el tratamiento contra los beneficios reales de éste. Es esencial una buena relación médico-paciente.


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