There are some people who have a greater tendency to be overweight and obese, a certain genetic background can also be ascribed, but without doubt, the underlying mechanism of excess weight is an imbalance between caloric intake and expenditure or simple Simply put, the fundamental cause is excessive consumption of food.
Is there any genetic and hereditary reason for obesity or overweight?
Sometimes we confuse genetics with customs and there are patients who tell us: I am hereditary because my whole family is overweight or obese; Well, what is hereditary is the way of eating. This way of eating is “inherited” when a lot of fat is used in cooking or a high-calorie diet is eaten.
There are new discoveries such as insulin treatment for diabetics that is being implemented to help non-diabetics lose weight. How do they work and what results can be expected?
In fact, there are drugs that were developed as antidiabetics and later it has been observed that they are useful for weight loss. The first of them is the older drug metformin. It manages to reduce an average of 2-4 kg depending on gastrointestinal discomfort, flatulence etc. But it can cause hypoglycemia and should be taken only if you have diabetes and of course with medical supervision.
But later, new pharmacological families came on the market, right?
that’s how it is. Sodium/glucose pump inhibitors in the kidney, known in English as SGLT2, whose action is to reduce the reabsorption of glucose by the kidneys and to reduce it by losing between 300 and 500 calories a day. This assumes 1 hour or more of intense exercise. The total weight loss is around 5-7 kgs. The second drug is GLP1 agonist for its short form in English. They are the ones that have been fueling more interest lately. Despite what is believed, they are not insulin. What they do is increase the production and release of insulin, but when it comes to weight loss, they are interesting because they slow down gastric emptying, ie the stomach holds food in for longer and Appetite decreases. They can cause gastrointestinal discomfort. Weight loss is similar to the previous one, although within this family there is a drug as an active principle called tareseptide, which has been shown to reduce weight between 15 and 20 kg in some patients.
What individualized weight loss treatments are offered in the Comprehensive Obesity Unit at Hospital Quironsalud Bizkaia?
In our Obesity Unit we provide a personalized study and treatment tailored to each individual with the aim of reaching their ideal weight. To do this, we took a clinical history with anthropometric measurements: age, weight, height, body mass index, abdominal circumference, blood pressure and pulse rate. With all these data, the ideal weight of the patient is decided and hence, the number of kgs one has to lose to reach it. From there and following clinical practice guidelines that standardize the exact techniques for desired weight loss, we select a technique. In the Comprehensive Obesity Unit of Quironsalud Bizkaia Hospital we have all the techniques available, and most importantly we are a team of doctors with great experience and it always favors the patient, because we are able to provide them all the techniques currently known to be effective and with the least potential risk to your health.
And what are those techniques?
There are techniques for people who need to lose 10 kilos and there are techniques for losing more than 100 kilos. All of them are included in 3 large groups. First, we have intragastric balloons, which come in several types. We have all kinds of balls. traditional ones, which require anesthesia with sedation to put them in and remove them, and more current ones, which are swallowed and then eliminated through feces without anyone knowing about it goes. Secondly, there are techniques that are performed by endoscopy, that is, the introduction of a gastroscope into the stomach through the mouth. Among such techniques are the POSE (for its abbreviation in English) and the APOLLO method. And finally, we have laparoscopic techniques, this so-called bariatric surgery. This is done by making small buttonholes in the skin, but without large incisions, by introducing instruments through the skin. Just like removing the gallbladder, appendix or hernia solves the problem. Within this group are the ‘gastric tube’, also called the gastric sleeve, not the gastric band; and ‘gastric bypass’. Each of these techniques will achieve a different weight loss and is therefore indicated. The success of the result depends on the appropriate choice for each patient with their own characteristics.
What percentage of success are we talking about with respect to the techniques implemented in the unit?
All the techniques are very well implemented and the weight that is reduced proves it. If the patient follows some basic pointers, there are high chances that he will achieve his goal. In fact, when the patient accepts a certain technique, they already know how much weight they are going to lose.
How Much Weight Can You Lose?
Most of our overweight patients who undergo bariatric surgery lose at least 40 kg in the first year. But the success for us is that once the follow-up period has passed, 1 year of age, has reached its norm. weight. Unless, of course, they need to lose a huge amount of weight. But it is an enormous satisfaction to be able to verify that the remedy not only helps to lose weight but also makes the ailments disappear. We have 15 patients who had diabetes and have recovered. And two of them were already on insulin treatment, for example. or patients who had high blood pressure or who had to sleep with a CPAP and no longer needed it.
What is included in the preoperative?
In our Obesity Unit, the first preparatory period is a thorough preoperative period; consultation with a psychiatrist; abdominal ultrasound; Gastroscopy with sedation (except for swallowable balloons), and consultation with an anesthetist and bariatric surgeon in case of performing a bariatric technique. If all is well, an intervention is made to change the patient’s dietary habits with a healthy and balanced, but comprehensive way of eating and a subsequent follow-up for up to one year. When the patient leaves this first consultation, informative and free, they already know the proper techniques to achieve their ideal weight and also how it will develop, as all the details about it are explained to them .
Apart from the aesthetic aspect, what effect does obesity have on people’s lives?
Obesity is a health problem and has been defined as such by the World Health Organization since 1997, but there is no doubt that it has an aesthetic aspect. However, losing weight has many additional benefits. Obesity favors the development of diabetes mellitus, arterial hypertension, dyslipidemia, that is, an increase in cholesterol or triglycerides, a sedentary lifestyle and other cardiovascular risk factors, leading to a reduction in life expectancy. Weight loss improves control of all of them, therefore, many diabetics see how they can reduce and even skip antidiabetic treatment while maintaining normal blood sugar. Something similar is seen with the control of blood pressure. It is very common for patients who lose weight to start physical activity, which improves their physical condition.
Let us give some examples of the improvements experienced by patients who have passed through the Comprehensive Obesity Unit of the Quironsalud Bizkaia Hospital.
We have had patients in our unit who have been able to go off CPAP because of sleep apnea, and even stop treatment with antidepressants to improve their self-esteem. But most striking is the reduction or disappearance of bone and joint pain such as in the knees, hips or plantar fasciitis.
How effective are minimally invasive treatments such as the intragastric balloon and in which cases would you recommend it?
Gastric balloons are a weight loss technique with few adverse effects. Stomach has not changed. The only drawback, to say the least, is that they are temporary and their effect lasts only as long as they are implanted. The success of the intragastric balloon is indicative, as it is designed to lose between 10 and 15 kg. If the patient is young and willing to add physical exercise, more harm may be done. But it is necessary to give place to expectations so that frustration does not arise. For its part, the swallowable balloon is easier to insert as it is swallowed, and we also help with swallowing. The technique is performed in a hospital with radiological control. After an average of 4 months, the balloon is expelled through the feces, unnoticed in more than 90% of cases. During this 4-month period, the patient is controlled in consultation, their eating habits are re-educated in the same way as we do with the rest of the patients.
From what age these surgical and non-surgical treatments can be applied?
Most of our patients are over the age of 18, although occasionally we have seen younger people. It is better to implement diet and exercise measures in very young people or teenagers.
What makes the obesity unit of the Hospital Quironsalud Bizkaia different?
Our unit is made up of specialist doctors and it always puts a great value on quality and knowledge. We are specialist doctors with wide experience in obesity treatment. We are not a commercial offering of various technologies. We value each individual by our multidisciplinary experience as endoscopist, bariatric surgeon, anaesthetist, psychiatrist and obesity specialist. Perhaps the fact of being integrated into a hospital such as the Quironsalud Bizkaia Hospital, with a complete medical offer, which offers greater security to the patient.
for more information:
Obesity Unit of Quironsalud Bizkaia Hospital
Telephone. 944 898 000
