[LifeStyle] Techniques to treat obesity and associated diseases

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Bariatric and metabolic surgery manages to extend the life of obese patients by ten years, in addition to considerably improving their quality of life by managing to remit diseases such as hypertension, dyslipidemia or sleep apnea

Changes in lifestyle, sedentary lifestyle, lack of physical exercise and the abandonment of the Mediterranean diet have led to an increase in overweight and obesity among the po[CENSORED]tion. The figures speak for themselves: Spain has 16.7% of its adult po[CENSORED]tion over 18 years of age with a Body Mass Index of over 30 kg / m2; the EU average is 15.9%. Also, from 2008 to 2014, this percentage increased by 1% in Spain.

It is worth noting a fact that is alarming at best, and that is that since 1975 people with overweight and obesity have almost tripled worldwide. In 2016, more than 1.9 billion adults 18 years of age and over were overweight, of which more than 650 million were obese.

The consequences of obesity, also called the 21st century epidemic, have associated health problems as serious as ischemic heart disease, high blood pressure, cardiovascular diseases, respiratory failure, osteoarthritis, the appearance of certain types of tumors and type 2 diabetes. , obese people have a three times higher risk of diabetes than people who are not obese.

Diabetes, like obesity, can be cured with surgery, and the data is clear: More than 80% of obese patients who undergo bariatric or metabolic surgery stop being diabetic.

 

Endoscopic surgery: intragastric balloon
The intragastric balloon technique consists of a latex sphere filled with physiological serum that is placed endoscopically in the stomach under sedation and without the need for patient admission. "Its main effect", explains Dr. Juan Antonio Casellas, specialist in endoscopic techniques at the Obesity Unit in Alicante, "is the decrease in the motility of the stomach, reducing the emptying time after food intake and causing, in most of the cases, a feeling of early satiety during meals. "

This technique is indicated in those patients who are overweight or called type I obesity, that is, their BMI is less than 29 and who have already tried to lose weight with diets previously and have not achieved results. According to different studies, the average loss of a balloon patient is between fourteen and sixteen kilos after six months.

The specialist also warns that the weight loss achieved with an intragastric balloon is only permanent in those patients who have managed to change their eating and exercise habits in a sustained manner over time, without these two premises there is a high possibility of recovering the lost weight in less than three years, so Dr. Casellas recommends the continuous supervision of a team of professionals in order to maintain weight loss.

Bariatric and metabolic surgery as a solution
The disease that is most frequently associated with excess weight is type 2 diabetes, which appears in overweight and obese adults because the increase in body fat increases the resistance to the action of the insulin it produces. the pancreas, which has to work harder than necessary in these cases, and ends up running out.

The association of type 2 diabetes with overweight-obesity is so consistent that it has led to the definition of the concept of diabetes.

Bariatric and metabolic surgery prolongs the life of obese patients by ten years, in addition to considerably improving their quality of life by managing to remit diseases such as type 2 diabetes, hypertension or dyslipidemia, and decrease the risk of developing tumors, especially colon or breast, according to Dr. Carlos Sala, specialist of the Obesity Unit of the Quirónsalud Hospitals Alicante and Valencia.

Among the techniques that have been most effective and safe to date are tubular gastrectomy and gastric bypass. "Both methods have already proven low mortality, a reduced number of complications and high efficacy in solving diabetes and associated diseases," says the doctor.

These interventions are performed laparoscopically, using minimally invasive surgery, which reduces pain and possible complications. The patient is prepared to leave the hospital 48 hours after the intervention.

Both vertical laparoscopic gastrectomy and laparoscopic gastric bypass are effective against diabetes, which remits in 80-90% of patients, improving in the remaining 20%. however, bypass seems more effective against hypertension and dyslipidemia. both techniques also facilitate weight loss.

Currently the best and most promising is vertical laparoscopic gastrectomy or gastric tube, which reduces the volume of intake and also causes a metabolic effect correcting diabetes. Since 2014 it is the most widely performed technique in the world. It is very physiological because it does not produce malabsorption, avoiding nutritional deficits.

It is indicated in patients with BMI between 35 and 45, with mild comorbidities, and with ease for dietary compliance. in patients with gastroesophageal reflux (heartburn) and severe esophagitis, we preferably recommend bypass because it also corrects it.

In addition to reducing the volume of intake, they associate controlled malabsorption. The best and most accepted of all bariatric techniques against morbid obesity is laparoscopic gastric bypass. It is considered the Gold Standard or Gold Standard Technique against which the other techniques are compared.

It is particularly recommended in candy-eating patients, in patients with gastroesophageal reflux and esophagitis (heartburn), and in patients with Metabolic Syndrome.

These types of techniques are especially indicated in the treatment of patients with a body mass index greater than 35 or even if it is lower but causes associated serious diseases, such as diabetes with poor metabolic control, high blood pressure, dyslipidemia or obstructive apnea syndrome. of the dream.

These methods help reduce between 70-80% of the excess weight of patients with obesity and offer highly satisfactory results in patients with type 2 diabetes, allowing them to completely abandon their medication, and preventing the appearance of any type associated disease.