It is an abnormal or excessive accumulation of fat which can affect health.
1. It can be treated.
2. It reduces quality of life.
3. Tiene tratamiento
There are endogenous factors which are not modifiable but which can be confronted. And exogenous factors that we can modify.
1. Endogenous:
- Genetic
- Familial
- Endocrinological
2. Exogenous :
- Nutrition
- Occupation
- Mental health
- Sleep loss
1. BMI Calculation: Weight (kg)/Height2 (m2)
- <18.5 kg/m2 underweight
- 18.5-25 kg/m2 normal weight 25-30 kg/m2 overweight
- >30 Obese
- 30-34.9 kg/m2 grade I
- 35-39.9 kg/m2 grade II
- >40 kg/m2 grade III or morbidly obese
- In people over the age of 65, a desirable BMI is between 24.9-29.9 kg/m2.
- There may be a different body composition for the same BMI (fat / body builder). This is not a reflection of nutritional status.
2. Assess waist circumference: indicator of visceral fat as well as cardiovascular risk
- Normal: women <80 cm / men <94 cm
- Increased: Women from 80 to 88 cm / Men from 94 to 102 cm
- Equivalent BMI >30 Women >88 cm men >102 cm
3. Bioimpedance (body composition)
Do not forget all other associated conditions
According to the World Health Organization, metabolic syndrome is characterised by the presence of prediabetes in conjunction with another risk factor for cardiovascular disease such as high blood pressure, upper body obesity or dyslipidaemia.
No olvidar todas las otras enfermedades asociadas
Sleep apnoea, insomnia, infertility, thrombosis, early osteoarthritis, fatty liver (steatosis), myocardial infarction, stroke, atrial fibrillation, heart failure.
The concept of lifestyle, very fashionable today, is a complex concept which includes external factors which can modulate and influence our health (educational level, social environment, water and air quality), and on which we cannot always intervene, as well as more controllable aspects:
1. Nutritional treatment
- Healthy, balanced, simplified, portion-controlled diet. Individualised, Mediterranean diet.
- Essential nutritional advice (face-to-face session).
- Avoid restrictive diets in the elderly.
2. Physical Activity
- Aerobic training and toning.
3. Behavioural intervention
- Belief in the diet.
- Realistic goals.
- Assessment of the importance of sleep duration and quality (7 hours minimum).
- Air pollution.
4. Drug treatment
- Liraglutide 3 mg / semaglutide. (STEP programme) in Spain at the end of 2023.
- Studies have demonstrated a 5 to 10% reduction in weight and an improvement in obesity-related diseases: hepatic steatosis, polycystic ovary syndrome, weight reduction following bariatric surgery.
- In addition to improvement in metabolic cardiac parameters: BP, reduction in waist circumference, improvement in lipid profile, quality of life, reduction of diabetes risk, reduction in visceral fat.
- Xenical and Plantaben may also be an option
5. Bariatric surgery
General indications. However, you must always consult a specialist in bariatric surgery for specific indications:
- BMI>35 kg/m2 with or without comorbidity
- BMI >30 kg/m2 + diabetes
- BMI from 30 to 34.9
- Specific indications in children and adolescents.
The multidisciplinary team at HC Marbella International Hospital’s Obesity Unit work in a coordinated manner to provide definitive solutions, according to the specific circumstances of each case.
Dr. Nicole Martin
General Internal Physician
September 6, 2023
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