In order to convey key concepts about obesity and its complexity, demystify misconceptions, publicize the many causes of weight gain and explain those that cannot be modified to alleviate the feeling of guilt of many patients and avoid frustrations that may generate more anxiety and a rebound effect, the Public Hospitals managed by Quirónsalud have launched the practical online workshop “How to reduce weight to gain health”.
The training session, which has held a first edition -which already accumulates more than 3,150 views- and of which new appointments are planned over the next few months, is aimed at patients from the Jiménez Díaz Foundation university hospitals (Madrid), Rey Juan Carlos (Móstoles), Infanta Elena (Valdemoro) and General de Villalba (Collado Villalba) with cardiovascular risk, a body mass index (BMI) greater than 30 and some additional pathology in which the loss represents a direct benefit.
“We start from the reality that it is not easy to lose weight and maintain this loss, but that it is also the only option,” says the Dr. Clotilde Vázquez, head of the Department of Endocrinology and Nutrition of this health care network and coordinator of the workshop, who indicates that “the decrease in the accumulation of excessive fat substantially improves, among others, pathologies as prevalent as chronic obstructive pulmonary disease (COPD), apnea sleep, hypertension, dyslipidemia, diabetes, osteoarticular and inflammatory pathology and cardiovascular diseases ”.
On the other hand, as the Dr. Teresa Montoya, head of the Endocrinology and Nutrition Service of the Infanta Elena University Hospital and participant in the workshop, obesity is associated with a reduction in life expectancy of up to 13 years and the excess mortality of these patients is mainly attributable to cardiovascular disease (58 percent of the total), diabetes and cancer. It is, after tobacco consumption, the second preventable cause for the development of cancer.
“Obesity is also a very poor prognostic factor for the outcome of diseases such as SARS CoV-2 infection, which has been shown to increase the mortality of affected patients by up to 300 percent, especially in those young people ”, explains the endocrinologist, pointing out that the pandemic has favored weight gain in many patients, accompanied by a very significant loss of muscle, due to sedentary lifestyle as a result of confinement.
A personalized and multi-component approach
The approach to obesity requires the recognition of a chronic disease, of multifactorial etiology, which does not depend solely on the behavior of the individual, but is governed by multiple factors: genetic, physiological, psychosocial, behavioral, nutritional and environmental. Therefore, It is necessary to have a personalized and in-depth diagnostic approach to the underlying causes and a multi-component treatment that equips the patient with all the tools (motivations, nutritional, physical activity and pharmacological) to achieve a permanent and definitive change in lifestyle.
For this reason, to materialize the process of change, the Obesity Unit of the Department of Endocrinology and Nutrition of these four centers, promoter of this workshop, has implemented and renewed the care process for patients with obesity. Based on the active participation (online) of the patient, it seeks to improve health outcomes and the automation of the diagnostic and therapeutic process to streamline and improve the process.
Losing weight progressively
The specialists of this department warn of the “magic” solutions, which make you lose weight quickly and unequivocally lead to the decrease in muscle mass and a rebound effect at the expense of fat mass, thus achieving a change in body composition towards a more obese phenotype by percentage of body fat.
“More than a weight loss itself, what really matters are changes in body composition”, exposes Leticia Lopez Escudero, dietitian-nutritionist of the Endocrinology and Nutrition Service of the Jiménez Díaz Foundation. That is, the goal should be to reduce fat mass and not muscle mass, something that can only be achieved by losing weight progressively.
Therefore, a loss of between 6 and 10 percent of total body weight in a period of 6 months is recommended. For example, a 100 kg person should lose between 5-10 kg in half a year.
Healthy eating to lose weight and keep it off
To lose weight in a healthy way, it is essential to acquire good eating habits and avoid foods with more calories and those that contain less healthy nutrients. As for sugars, you should limit your intake to the content naturally present in fruits, vegetables and whole grains and avoid soft drinks, juices (even natural) and industrial or homemade pastries, as well as processed ones. “The reason is that a constant consumption of foods that contain this type of sugar causes rises and falls in blood sugar and in the person it can translate into recurrent going to the fridge and even a craving for sweets”, Says the nutritionist.
With regard to fat, the recommendation is that it represents between 25-35 percent of the total calories in the diet and those with high anti-inflammatory and antioxidant power should be chosen, such as those from nuts, olive oil virgin or extra virgin and fish, especially blue, avoiding sauces, precooked, ultra-processed, sausages, industrial confectionery and avoiding abusing very fatty dairy products. “The key is to moderate your consumption so as not to exceed total calories, but we should not restrict carbohydrates or fats in any case, but rather choose quality“, Explain.
Due to its qualitative composition, the Mediterranean diet is a great ally, since it prevents and improves cardiovascular disease by acting directly on its risk factors such as diabetes, dyslipidemia, blood pressure and even cancer. What’s more, Due to its high fiber content, it helps control appetite in interdigestive periods.
The importance of physical activity
Along with umoderate caloric restriction in the diet, increasing daily physical activity is crucial to achieve a negative energy balance, since allows to increase caloric expenditure while increasing muscle mass and, therefore, the basal metabolism (the caloric expenditure of a person at absolute rest).
“The recommendation for adults is 150-300 minutes per week at moderate intensity of aerobic activities (such as commuting, occupation, housework, gardening, scheduled exercises) or 75-150 minutes per week at more vigorous intensity, or equivalent combinations of strength exercises two days a week and some flexibility, coordination and balance exercise (yoga, stretching, Pilates, etc.) to improve balance and prevent falls ”, he points out. Lopez. In the case of a person over 65 years of age with an exercise impediment, they should be as active as possible in their daily life.
And, for those who need it, “The last ‘leg of the bank’ would be to properly control emotional intake with the help of an expert”, concludes the nutritionist of the Jiménez Díaz Foundation.