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2001, Number 4

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Gac Med Mex 2001; 137 (4)

Obesity in the XXI century. Advances in etiopathogenesis and treatment

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

Language: Spanish
References: 53
Page: 323-334
PDF size: 100.48 Kb.


ABSTRACT

Obesity is complex in its etiology and treatment. Its global incidence is increasing significantly. Favoring weight-loss can only bring beneficial effects. Obesity is a chronic condition with multifactorial origin. The discovery of the ob gene and its product, the OB protein or Leptin, neuropeptide Y, and the alterations of the metabolism of lipogenic tissues that inhibit appetite are significant advances in the understanding of its etiopathogenesis and treatment. This new knowledge will change the philosophy of the management of obesity. Obesity responds poorly to nonsurgical therapies. Its treatment must be long-term in spite of the considerable social and biological pressure that favor the regaining of weight. Treatment of the obese patient must be performed by a multidisciplinary team, and should include a hypoenergetic diet, exercise program, behavioral modifications, and in some instances, family therapy. The treatment of obesity should be tailored for each individual. Drug use in the treatment of obesity is not a substitute for modifying the individual's diet and physical activity. Bariatric surgery is indicated only when the BMI is greater than 30 kg/m 2 . Physicians and patients must interact closely and assess possible risks that are involved in its treatment against real benefits. A good relation between practitioner and patient is essential.


REFERENCES

  1. Bray GA. Contemporary diagnosis in management of obesity. New-Town Pa. Handbook in health care, 1998.

  2. Stevens J et al. The effect of age on the association between body-mass index and mortaiity. N Engl J Med 1998;338:1.

  3. Pi-Sunyer FX Proc Obesity: criteria and classification. Nutr Soc. 2000;59(4):505-509.

  4. Ciark JM, Brancati FL. The Chalienge of Obesity-related Chronic Diseases. J Gen lntern Med. 2000;15(11):828-829.

  5. Rosenbaum Michael, Liebel L. Rudoiph, Hirsch Jules, Obesity; The New England Journal of Medicine; 1997;337: 396.

  6. Bray George A. Etiology and Pathogenesis of Obesity; Clinical Cornerstone. Excerpta Medica; 1999;2(3):1-15.

  7. Leslie M. Weighing in on clinical guidelines for obesity. Tools to assist your patients. Adv Nurse Pract 2000;8(3): 78-81.

  8. Tierney Lawrence M Jr, Mc Phee Stephen J, Papadakis Mocine A. Current: Medical Diagnosis and Treatment; Internacional Edition, Ed. Lange; 2000. p. 1222-1225.

  9. Expert Panel on Overweight and Obesity in adults. Arch lntern Med. 1998;158(17):1855

  10. Dipietro L. Physical Activity in the Prevention of obesity: current evidence and research issues; Med Sci Sports Exerc 1999;31:11 Supl. S546-6.

  11. Le Stunff C, Le Bihan C, Schork NJ, Bougneres P. A common promoter variant of the leptin gene is associated with changes in the relationship between serum leptin and fat mass in obese giris. Diabetes. 2000;49(12):2196-200.

  12. Effects of weight reduction of the clinical and hormonal condition of obese anovulatory women; Ginecol Obstet Mex; Sep. 1999;67:433-7.

  13. Cornuzzie Anthony G, Allison David B. The Search for Human Obesity Genes; Science; Vol. 280: 29 May 1998; p. 1 374-1377.

  14. Doucet Eric, Imbeault Pascal, Alméras Nathalie, Tremblay Angel; Physical Activity and Low-fat Diet: ls it enough to maintain weight stability in the reducedobese individual following weight-ioss by drug therapy and energy restriction; Obesity Research 1999;(Vol. 7) No. 4; p.323-332.

  15. Wolf AM, Colditz GA. Current Estimates of the Economic Cost of Obesity in the U.S.; Obesity Research, 1998;6:2, 97-106.

  16. Arvind Kumar, Nicholas A Inverso, Christopher D Stili; Leptin: Pathogenesis and Treatment of Morbid Obesity, Current Gastroenterol; 2000(Vol. 2);4:337-344.

  17. Loweil BB, Spiegelman BM. Towards a molecular understanding of adaptive thermogenesis. Nature 2000;404:652-60

  18. Schwartz MW, Seeley RJ. Neuroendocrine responsos to starvation and weight loss. N Engl J Med. 1997;336(25): 1802-11. Review.

  19. Auwerx J, Staels B. Leptin. Lancet. 1998;351(9104):737-42.

  20. Prolo P, Wong ML, Licinio J. Leptin. lnt J Biochem Cell Biol 1998;30:1285-1290.

  21. Trayhurn P, Hoggard N, Mercer JG, Rayner DV. Leptin: fundamental aspects. Int J Obes Relat Metab Disord 1999;23(suppl 1):22-28.

  22. Masuzaki H, Ogawa Y, Hosoda K, et al. Nonadipose tissue production of leptin: leptin as a novel placenta-derived hormone in humans. Nat Med 1997;3:10291033.

  23. Licinio J, Mantzoros C, Negrao AB, et al. Human Leptin levels are pulsatile and inversely related to pituitary-adrenal function. Nat Med 1997;3:575-579.

  24. Licinio J, Mantzoros C, Kakiamani V, et al. Synchronicity of frequentiy-sampled 24-hour concentration of circulating leptin, luteinizing hormone, and estradiol in healthy women. Proc Natl Acad Sci USA 1998;95:2541-2546.

  25. Lee GH, Proenca R, Montez JM, at al. Abnormal splicing of the leptin receptor in diabetic mice. Nature 1996, 379:632-635.

  26. Filer JS. Leptin expression and action: new experimental paradigms. Proc Natl Acad Sci USA 1997,94:4242-45.

  27. Mantzoros CS. The role of leptin in human obesity and disease: a review of current evidence. Ann lntern Med 1999, 130:671-680.

  28. Bray CA, York DA. Leptin and clinical medicine: a new piece in the puzzle of obesity. J Clin Endocrinol Metabol 1997,82:2771-2776.

  29. Lonnqvist F, Nordforf L, Jansson M, et al. Leptin Secretion from adipose tissue in woman: Relationship to plasma leveis and gene expression. J Clin lnvest 1997, 99:2398-2404

  30. Koiaczynski JW, Ohannesian JP, Concidine RV, et al. Response of leptin to short term and prolonged overfeeding in humans. J Clin Endocrinol Metab 1996, 81:4162-4165.

  31. Loftus TM, Jaworsky DE, Fehywot GL, et al. Reduced food intake and body weight in mice treated with fatty acid synthase inhibitors. Science 2000;2379-81.

  32. Katz DA, McHorney CA, Atkinson RL. lmpact of Obesity on Health-related Quaiity of Life in Patients with Chronic lliness. J Gen lntern Med. 2000;15(11):789-796.

  33. Tegos TJ, Kalodiki E, Daskalopoulou SS, Nicolaides AN. Stroke: epidemiology, clinical picture, and risk factors- Part I of III. Angiology. 2000;51(10):793-808.

  34. Lenhard James MD. The effects of Fat vs Carbohydrates on the Etiology of Type 2 Diabetes; 60th Scientific Sessions of the American Diabetes Association; Day 1 -June 10, 2000.

  35. Utriainen T, Maimstrom R, Makimattila S, Yki-Jarvinen H, et al. Suprafisiological hyperinsulinemia increases plasma leptin concentrations after 4 h in normal subjects. Diabetes 1996;45:1364-1366.

  36. Chow WH, Gridley G, Fraumeni JF, Járvhoim B. Obesity, Hypertension, and the risk of kidney cancer in men. The New Engl J of Med. 2000;343(18):13051311.

  37. Pacchioni M, Nicoletti C, Caminiti M, Calorl G, Curci V, Camisasca R, Pontiroli AE. Association of obesity and type 11 diabetes mellitus as a risk factor for galistones. Dig Dis Sci. 2000;45(10):2002-6.

  38. Bacon BR, Farahvash MJ, Janney CG, Neuschwander-Tetri BA. Nonalcoholic Steatohepatitis: An Expanded Clinical Entity. Gastroenterology 1994;107:11031109.

  39. National Task Force on Prevention and Treatment of Obesity. 1996. JAMA 1907;276(23):

  40. García Hidalgo L, Orozco Topete R, González Barranco J, R. Villa AJ, Dalmán J, Ortiz Pedroza G. Dermatoses in 156 obese adults; Obesity Research; 1999(Vol.7)3;299-302.

  41. Davidson MH, Hauptman J, DiGirolamo M, et al. Weight control and risk factor reduction in obese subjects treated for 2 years with Orlistat. JAMA 1999. p. 235-242.

  42. Devereux RB. Appetite suppressants and valvular heart disease. N Engl J Med 1998;339:765.

  43. Herber David. Pharmacology in the treatment of obesity; Clinical Cornerstone. Excerpta Medica Inc 1999;2(3):33-42.

  44. Orlistat for Obesity. The medical letter 1999;41(June 18):55-56.

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

  46. Heymsfield SB, Greenberg AS, Fujioka K, Dixon RM, Kushner R, Hunt T, Lubina JA, Patane J, Self B, Hunt P, McCamish M. Recombinant leptin for weight loss in obese and lean aduits: a randomized, controlled, dose-escalation trial. JAMA 1999;282(16):1568-75.

  47. Fung TT, Hu FB, Yu J, Chu NF, Spiegelman D, Tofier GH, Willet WC, Rimm EB. Leisure-time physical activity, television watching, and plasma biomarkers of obesity and cardiovascular disease risk. Am J Epidemiol. 2000;152(12):1171-8.

  48. Fobi MA, Lee H, Hoiness R, Cabinda D. Gastric Bypass Operation for obesity; World J. Surg. 1998;22(9):925-35.

  49. Schirmer BD. Laparoscopic bariatric surgery Surg Clin North Am 2000;80(4):1253-67, vii

  50. Bleier JI, Krupnick AS, Kreisel D, Song HK, Rosato EF, Williams NN. Handassisted laparoscopic vertical banded gastroplasty. Early results Surg Endosc 2000;14(10):902-7.

  51. Husemann B 20 years smali intestinal bypass surgery. What is left? Chirurg 2000;71(2):134-9.

  52. Brolin RE, Bradley LJ, Wiison AC, Cody RP Lipid risk profile and weight stability after gastric restrictiva operations for morbid obesity. J Gastrointest Surg. 2000;4(5):464-9.

  53. Raiga J, Barakat P, Diemunch P, Calmelet P, Brettes JP. Laparoscopic Surgery and Massive Obesity; J Gynecol Obstet Biol Reprod (Paris); 2000;29:2:154-60.




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