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La compleja y sensible naturaleza de la obesidad

puede dificultar las conversaciones con los pacientes.

Un enfoque empático y pedir permiso es un punto de

partida útil. Los resultados del estudio ACTION13

mostraron que a dos tercios de las personas con

obesidad le gustaría que su profesional sanitario

hablara de su peso4.

 

Las investigaciones indican que, cuando los

profesionales sanitarios emplean un enfoque con

empatía y otras técnicas coherentes con la entrevista

motivadora, los pacientes son más propensos a tratar

la pérdida de peso a través de cambios en los hábitos

de alimentación y actividad2.

 

Para iniciar una conversación con los pacientes acerca

de su peso, es importante pedirles primero permiso5.

Sin permiso, hablar sobre el peso puede ser un tema

sensible y no deseado.

Se recomienda que aconseje sobre los riesgos de salud asociados con la obesidad5.

 

Para equilibrar el análisis de los riesgos para la salud asociados con el exceso de peso, considere aconsejar a su paciente sobre cómo incluso una modesta pérdida de peso continuada del 5-10 % puede mejorar su salud y reducir los riesgos de complicaciones5.

1.

Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014; 129:S102–138.

2.

Pollak K, Ostby T, Alexander S, et al. Empathy goes a long way in weight loss discussions. The Journal of Family Practice. 2007; 56:1031–1036.

3.

Rose SA, Poynter PS, Anderson JW, et al. Physician weight loss advice and patient weight loss behavior change: a literature review and meta-analysis of survey data. International Journal of Obesity. 2013; 37:118–128.

4.

Golden A, Dhurandhar NV, Jinnett K, et al. Insights and Perceptions of Obesity Management in People with Obesity: Results of the National ACTION Study. ObesityWeek. 2016.

5.

Vallis M, Piccinini-Vallis H, Sharma A, et al. Modified 5As. Canadian Family Physician. 2013; 59:27–31.

6.

Kushner R. Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians. Booklet 2: Evaluating your patients for overweight or obesity. Chicago, IL: American Medical Association; 2003.

7.

Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. Journal of the American Medical Association. 1999; 282:1523–1529.

8.

Seagle H, Witt Strain G, Makris A, et al. Position of the American Dietetic Association: weight management. American Dietetic Association 2009; 109:330–346.

9.

Kushner F. Clinical assessment and management of adult obesity. Circulation 2012; 126:2870–2877.

10.

Kushner R. Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians. Booklet 4: Dietary management. Chicago, IL: American Medical Association; 2003.

11.

Kushner R. Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians. Booklet 5: Physical activity management. Chicago, IL: American Medical Association; 2003.

12.

Fabricatore A. Behavior Therapy and Cognitive-Behavioral Therapy of Obesity: Is There a Difference? Journal of the American Dietetic Association. 2007; 107:92–99.

13.

Frühbeck G, Sbraccia P, Nisoli E. 2015 Milan Declaration: A Call to Action on Obesity – an EASO Position Statement on the Occasion of the 2015 EXPO. Obesity Facts. 2016; 9:296-298.

14.

American Medical Association. A.M.A Adopts New Policies on Second Day of Voting at Annual Meeting. Obesity as a Disease. Disponible en: https://news.cision.com/american-medical-association/r/ama-adopts-new-policies-on-secondday-of-voting-at-annual-meeting,c9430649. Último acceso: febrero de 2022

15.

Bray GA, Kim KK, Wilding JPH, et al. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017; 18:715–723.

16.

Puhl RM, Andreyeva T, Brownell. Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. International Journal of Obesity. 2008; 32:992–1000.

17.

Wadden T, Didie E. What’s in a Name? Patients’ Preferred Terms for Describing Obesity. Obesity Research. 2003; 11:1140–1146.

18.

Volger S, Vetter M, Dougherty M, et al. Patients’ Preferred Terms for Describing Their Excess Weight: Discussing Obesity in Clinical Practice. Obesity. 2012; 20:147–150.

19.

Obesity Action Coalition. Understanding Obesity Stigma. Disponible en: http://www.obesityaction.org/wpcontent/uploads/UOS_1-26-18-wo-bleed.pdf. Last accessed July 2018.

20.

NHLBI. The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK2003/. Último acceso: julio de 2018.

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