Service d'enseignement thérapeutique pour maladies chroniques, Département de médecine communautaire, Hôpitaux Universitaires de Genève, Genève/Eurobesitas COMs Center, Vevey, Switzerland.
Department of Medicine, Padova University Hospital, Bariatric Unit, University of Padova, Padova, Italy.
Obes Facts. 2019;12(1):40-66. doi: 10.1159/000496183. Epub 2019 Jan 23.
The first contact for patients with obesity for any medical treatment or other issues is generally with General Practitioners (GPs). Therefore, given the complexity of the disease, continuing GPs' education on obesity management is essential. This article aims to provide obesity management guidelines specifically tailored to GPs, favouring a practical patient-centred approach. The focus is on GP communication and motivational interviewing as well as on therapeutic patient education. The new guidelines highlight the importance of avoiding stigmatization, something frequently seen in different health care settings. In addition, managing the psychological aspects of the disease, such as improving self-esteem, body image and quality of life must not be neglected. Finally, the report considers that achieving maximum weight loss in the shortest possible time is not the key to successful treatment. It suggests that 5-10% weight loss is sufficient to obtain substantial health benefits from decreasing comorbidities. Reducing waist circumference should be considered even more important than weight loss per se, as it is linked to a decrease in visceral fat and associated cardiometabolic risks. Finally, preventing weight regain is the cornerstone of lifelong treatment, for any weight loss techniques used (behavioural or pharmaceutical treatments or bariatric surgery).
肥胖患者在接受任何医疗治疗或其他问题时,通常首先接触的是全科医生(GP)。因此,鉴于该疾病的复杂性,持续为 GP 提供肥胖管理方面的教育至关重要。本文旨在为 GP 提供专门定制的肥胖管理指南,倾向于实用的以患者为中心的方法。重点是 GP 的沟通和动机性访谈以及治疗性患者教育。新指南强调了避免污名化的重要性,这在不同的医疗保健环境中经常出现。此外,管理疾病的心理方面,如提高自尊心、身体形象和生活质量,也不容忽视。最后,该报告认为,在尽可能短的时间内实现最大程度的体重减轻并不是治疗成功的关键。它表明,减轻 5-10%的体重就足以从减少合并症中获得实质性的健康益处。减少腰围应被视为比体重减轻本身更重要,因为它与内脏脂肪减少和相关的心血管代谢风险有关。最后,防止体重反弹是终身治疗的基石,无论使用何种减肥技术(行为或药物治疗或减肥手术)。