Obesity disease has been transparent for years. It's time for a comprehensive approach to treatment

Why is a multidisciplinary approach including pharmacotherapy, lifestyle changes and psychological support so important in the treatment of obesity?

Obesity disease was transparent for years and we didn't know how to talk about it. Now these patients have come out of hiding and we have started talking to them. Many people in my profession (ed. doctors) didn't "touch" the subject because there were no solutions and we mistakenly thought it was just a problem of increasing weight and moving.

How do you tell a person who weighs 150 kilos: Please don't eat from tomorrow and please move, as she has difficulty climbing stairs? Now in the prevention of overweight, the ecosystem is very important, processed food that makes us addicted. How can we require children not to eat these foods when there are TV commercials for these products. We have to hit our chests, because we have created such a world that encourages this. Of course, in order to treat it well, you have to diagnose the disease and know a lot about it, you have to learn about it. The Polish Society for the Treatment of Obesity has developed some standards on how to approach this disease. We should and learn, with the participation also of the professional body of doctors or other medical professions, such as dieticians, nurses and paramedics, how to deal with this disease in case of saving the life of a person with obesity disease. We do not have bariatric ambulances. But these people are discriminated against, and we get the beginning of our knowledge about obesity disease from patients, from patient organizations.

What to do next? How to treat?

First of all, access to evidence-based medicine. One fact is that if there are medical indications, that is, a patient is qualified for bariatric surgery, which is one part of the treatment, it should be done, because it reduces the risk of sudden death, the risk of complications, multi-disease, of which obesity disease is the bad mother.

More than 200 disease entities are a consequence of this disease, and we as Poland's Ministry of Health are spending a huge amount of money on corrective medicine, treating diabetes, hypertension, complications of atherosclerosis, cancer. And treating obesity disease in accordance with standards and evidence-based medicine will prevent the onset of these diseases.

When treating diabetes, most often we treat a patient with diabetes and overweight and obesity. When treating hypertension, if the patient gets thin, although as I emphasize this is not the problem, only increasing weight, we observe that we can prescribe fewer drugs, but this is a process, this patient will not cure himself, because from cancer he will not cure himself either, only we have to implement certain therapies, participate in drug programs, we give him a certain treatment offer according to the principles of the latest medicine.

And is there room for pharmacotherapy here?

Of course, there are new these incretin drugs, they are widely recognized and patients ask if they can treat themselves for overweight, obesity. Indeed, how we diagnose it we will measure: the old parameters, weight, height and BMI, o we are already moving away from that, there are new indicators that we should implement. We haven't done our homework over the years, so we start with simple things that should be a certain process, but we should see the result of this process soon. We already know that weight and height must be entered in the patient's file. Certain preventive, preventive content should already be in our smartphones, in the online patient account. we know that now the world without the Internet does not exist, you need to read preventive content. There should be an alert that is just for us to take care of ourselves, but we need to have support. Also psychologically, that many overweight people, with obesity disease sometimes stay at home, do not feel socially useful, afraid of the hejt of society, especially children and adolescents in the group of children and adolescents is a huge problem.

What are the barriers to accessing such comprehensive care?

Today it's not clear who is supposed to take care of it, whether an internist, a family doctor or a cardiologist. Everyone has the right to deal with it, but I think that a network of such clinics based on AOS, or even on primary care - here there are some dilemmas because some say in primary care, others say in AOS; perhaps in an inverted pyramid of services, such clinics that could comprehensively treat these patients. This is a solution for the future. And, of course, there must be public funding, so that we will certainly see later that we are not spending money on other diseases. Of course, we also need to treat these diseases, that goes without saying.