ABSTRACT
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Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.
ABSTRACT
Resumen: ANTECEDENTES: La asociación entre obesidad y psicopatología es bien conocida; sin embargo, la presencia de esta última en los pacientes con obesidad mórbida sometidos a cirugía bariátrica y su impacto en la pérdida de peso ha sido menos estudiado. OBJETIVO: Realizar una actualización sobre el panorama general de los trastornos psiquiátricos asociados con la obesidad mórbida, y el impacto de éstos sobre la pérdida de peso en pacientes bariátricos. MÉTODO: Se consultaron las bases de datos EBSCO Research Database y PubMed. Se seleccionaron los artículos publicados de 2011 a la fecha. Fueron utilizadas palabras clave relacionadas con el tema de estudio. RESULTADOS: Los estudios revisados mostraron cinco entidades clínicas psicopatológicas con alta prevalencia en pacientes que se encuentran en protocolo de cirugía bariátrica: Depresión y ansiedad, trastorno por déficit de atención e hiperactividad, trastornos de la conducta alimentaria, abuso de sustancias y algunas dimensiones de la personalidad. La presencia de estas condiciones se asoció a una menor pérdida de peso posterior al procedimiento quirúrgico. DISCUSIÓN Y CONCLUSIÓN: El impacto del trastorno por atracón y por abuso de sustancias en la pérdida de peso, posterior a la cirugía bariátrica, es controversial. La evaluación del paciente con obesidad candidato a cirugía bariátrica debe enfatizar, de acuerdo con la prevalencia de los trastornos reportados, la identificación de trastornos depresivos-ansiosos y del trastorno por déficit de atención e hiperactividad.
Abstract: BACKGROUND: The association between obesity and psychopathology is well known. However, the presence of psychopathology in patients with morbid obesity who attend bariatric surgery and its impact in weight loss has been less studied. OBJECTIVE: To perform a theme update about the general context of psychiatric disorders associated with morbid obesity, and to assess the impact of such disorders in patients undergoing bariatric surgery. METHOD: EBSCO Research Database and PubMed databases were consulted. Articles published between 2011 and today were selected. Key words related to the topic of study were used. RESULTS: The studies reviewed showed five psychopathological clinical entities with high prevalence in patients who attend bariatric surgery: Depression and anxiety, attention deficit hyperactivity disorder, disorders of eating behavior, substance abuse, and some dimensions of personality. The presence of these disorders was associated to a poor post-surgical weight loss. DISCUSSION AND CONCLUSION: Binge eating disorder and substance abuse impact on weight loss after bariatric surgery is controversial. The evaluation of obese patients who attend bariatric surgery must emphasize, according with reported disorders prevalence, the identification of depression, anxiety and attention deficit hyperactivity disorder.