eISSN: 2391-517X
ISSN: 2353-9437
Nutrition, Obesity & Metabolic Surgery
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2/2020
vol. 7
 
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abstract:
Guidelines/recommendations

Treatment of overweight and obesity during and after a pandemic. Let’s not wait for the development of complications – new guidelines for doctors

Magdalena Olszanecka-Glinianowicz
1
,
Dominika Dudek
2
,
Krzysztof J. Filipiak
3
,
Marek Krzystanek
4
,
Leszek Markuszewski
5
,
Marek Ruchała
6
,
Elżbieta Tomiak
7

1.
Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Polish Association for the Study of Obesity
2.
Department of Psychiatry, Collegium Medicum, Jagiellonian University in Cracow, Polish Psychiatric Association
3.
1st Department and Clinic of Cardiology, Medical University of Warsaw, Polish Association of Hypertension
4.
Department of Psychiatric Rehabilitation, Medical Faculty in Katowice, Medical University of Silesia, Scientific Section of Telepsychiatry of the Polish Psychiatric Association
5.
Centre for Heart and Vascular Diseases, Internal and Metabolic Diseases, Faculty of Medical Sciences and Health Sciences, University of Humanities and Technology in Radom, Polish Association of Cardiodiabetology
6.
Department and Clinic of Endocrinology, Metabolism and Internal Diseases, Poznań University of Medical Sciences, Polish Association of Endocrinology
7.
VITA – Group of Family Doctors in Otyń, The College of Family Physicians in Poland
Nutrition, Obesity & Metabolic Surgery 2020; 6, 2: 1–13
Online publish date: 2020/08/03
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The treatment of obesity in the pandemic era has become more important than ever. The current situation is conducive to the worsening of disease and the development of new diseases, mainly as a result of compensating negative emotions with food. Taking into account the data on the impact of obesity and its complications on the severity of the course and the risk of death due to COVID-19, we recommend using the 2016 American Endocrine Society’s criteria for the diagnosis of obesity instead of the 1998 WHO criteria. We also recommend diagnosing eating under the influence of emotions and the occurrence of eating disturbances, such as compulsive eating syndrome, night eating syndrome and food addiction, and complications of obesity, in any person with a BMI > 25 kg/m2.

The approach to treatment should be individualised and should not be limited to nutritional and physical activity education alone. Each patient should be offered appropriately selected pharmacotherapy, and, if necessary, also psychotherapy. The first-line drug should be a combined preparation containing naltrexone and bupropion (Mysimba). Liraglutide in a dose of 3 mg (Saxenda) should be considered as a second-line drug in a situation where eating under the influence of emotions is excluded (reaching for food in situations of experiencing negative and positive emotions and boredom, eating disturbances: compulsive eating syndrome, night eating syndrome, and food addiction) and depressed mood or there are permanent contraindications to the use of the first-line drug.

It is unethical not to treat obesity or refer the patient to another doctor for treatment. The use of telemedicine tools can facilitate work in therapeutic teams (doctor, dietitian, psychotherapist), as well as improve patient compliance with pharmacotherapy and changes in eating habits and the level of physical activity recommendations.
keywords:

obeisty treatment, pharmacotherapy, telemedicine, guidelines for doctors

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