Obesity – Update for 2022

Obesity, or obese disease, is a chronic disease, with no tendency to spontaneous resolution without the implementation of appropriate pharmacological and non-pharmacological treatment (changes in eating habits and introduction of daily physical activity). It is prone to relapse and untreated leads to many adverse health complications, including: type 2 diabetes, insulin resistance, hypertension, dyslipidemia and atherosclerosis, cardiovascular disease, hormonal disorders and osteoporosis or mechanical injuries.

The results of a survey conducted by the Centre for Social Opinion Research (CBOS) in 2019 show that as many as 59% of Poles are overweight, and this percentage has increased by 13% in the last 10 years. In the longer term, statistics predict that the percentage of the population with overweight will increase. Even on a global scale, it is on the rise, which means an obesity pandemic. This is also reflected in increased hospitalizations and the deterioration of the general health of the population. Also children and young people.

This situation became the reason for the establishment of the Polish Obesity Treatment Society (PTLO) in March 2020. The main objective of the action is to raise awareness among doctors about the increasing number of obesity, to raise awareness among healthcare professionals about the progress in the diagnosis and treatment of obesity and its complications. Therefore, current clinical recommendations for treatment in obese patients 2022″ have been developed.

It is necessary to look at the problem of excess weight from an economic, medical, social and psychological point of view. An overweight or obese patient requires multi-faceted holistic support and care during the initiation of therapeutic therapy if it is to be effective and safe for him.

Family doctors, who receive overweight patients, increasingly feel powerless, resulting from the lack of systemic solutions for obesity treatment and the lack of time needed for individual approach to patients. There is also a lack of free advice from a dietitian, a psychologist and a physiotherapist as part of the POZ (but under the new law on the profession of dietitian there is a chance that this will be possible). For now, obesity treatment is limited to prescribing appetite suppressants and other pharmacotherapies. Most often, it is treated symptomatically, that is, the treatment of hypertension, diabetes, non-alcoholic liver disease, and not ultimately obesity.

Medicine is a field of economics that should take into account a multi-faceted approach to every patient, regardless of the problem with which the patient comes to a specialist. This means that the patient should be cared for by at least several specialists at the same time, including: a family doctor, a specialist from the selected medical unit, a psychologist/psychiatrist, a dietitian, a physiotherapist.

Obesity – it’s already a disease!!!

Obesity has been recognized as a disease and listed in the International Classification of Diseases (code E66 in the ICD-10 classification), which requires medical diagnosis and treatment. Obesity shortens life expectancy and is a fatal disease, due to its extensive health consequences.

Patients at high risk of complications of obesity and already diagnosed with co-existing diseases are recommended to undergo regular laboratory tests, in particular with regard to:

  • blood glucose levels (fasting, tolerance test)
  • lipid profile (total cholesterol, HDL, LDL, VLDL, triglycerides)
  • uric acid concentration
  • thyroid hormone (TSH) levels
  • alanine aminotransferase ALT and aspartate AST
  • creatinine concentration
  • C-reactive protein. CRP and OB
  • peripheral blood morphology
  • general urinalysis

The diagnosis of obesity is influenced not only by body weight itself, but mainly by the weight-to-height ratio (determining the BMI), waist and hip circumference measurement and the measurement of adipose tissue (subcutaneous and visceral, i.e. peritoneal) and the general nutritional status of the body. In children and adolescents, so-called percentile grids are used to determine whether there is underweight, normal body weight or overweight or obesity.

A commonly used method to determine body fat content is to use an analytical scale, which uses electrical bioimpedance to determine its value. Thanks to it, we are able to know the %content of fat tissue, muscle mass, bone mass, metabolic age, basic metabolism, degree of hydration and many other parameters.

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