ABSTRACT
La depresión y la obesidad son patologías altamente prevalentes y corresponden a los principales problemas de salud pública. Estas patologías tienen un gran impacto en la morbilidad y mortalidad de los pacientes y afectan la salud y el bienestar de quienes las padecen, así como también afectan en el aspecto socioeconómico consecuencia del deterioro funcional y el gasto de recursos en salud ocasionados. Resultados de estudios epidemiológicos, ensayos clínicos y meta-análisis apoyan la asociación entre los estados depresivos y la obesidad, ya que ambos ocurren conjuntamente en todas las razas de poblaciones evaluadas. El objetivo es abordar la evidencia con respecto a 4 aspectos: (1) obesidad y respuesta a los antidepresivos, (2) trastornos depresivos y su impacto sobre la progresión de la obesidad, (3) tratamiento de la obesidad y el impacto sobre los resultados entre pacientes con trastornos depresivos, (4) el tratamiento de los trastornos depresivos y su impacto sobre los resultados de la obesidad. La evidencia existente apoya la asociación entre obesidad y los resultados adversos para la salud en individuos con trastornos depresivos. Además, destaca el concepto que el tratamiento de una de las dos enfermedades (obesidad o trastornos depresivos) es relevante para mejorar el curso de la otra patología. Puede ser beneficioso explorar dirigidamente la presencia de un trastorno depresivo en sujetos con sobrepeso u obesidad, así como el aumento de peso en personas con depresión. Conocer el efecto de los fármacos antidepresivos sobre el peso corporal es también relevante para facilitar la adherencia al tratamiento en el largo plazo.
Depression and obesity are highly prevalent illness and a mayor public health concern. These diseases have a great impact on morbidity and mortality of patients and affect the health and well-being of those who suffer them, as well as being affected in the socioeconomic aspect as a result of the functional deterioration and the spending of resources. Results of epidemiological studies, clinical trials and meta-analysis support the association between mood disorders and obesity, since both occur together in all the populations evaluated. The objective is to address the evidence regarding four aspects: (1) obesity and response to antidepressants, (2) depressive disorders and their effect on the progression of obesity, (3) treatment of obesity and the effect on outcomes among patients with depressive disorders, (4) the treatment of depressive disorders and their effect on obesity outcomes. Existing evidence supports the association between obesity and adverse health outcomes in individuals with depressive disorders. In addition, it highlights the concept that the treatment of one of the two diseases (obesity or depressive disorders) is relevant to improve the course of the other disease. It may be beneficial to explore the presence of a depressive disorders in overweight or obese subjects, as well as weight gain in subjects with depression. Knowing the effect of antidepressant drugs on body weight is relevant to facilitate adherence to long-term treatment.
Subject(s)
Humans , Depressive Disorder/psychology , Depressive Disorder/epidemiology , Obesity/psychology , Obesity/epidemiology , Body Weight , Body Mass Index , Depressive Disorder/physiopathology , Depressive Disorder/drug therapy , Overweight , Antidepressive Agents/therapeutic use , Obesity/physiopathology , Obesity/therapyABSTRACT
Background: Very low calorie diets (VLCDs) have been used to induce a rapid decrease in total body weight. Aim: To evaluate the efficacy and safety of a VLCD in a group of overweight and obese Chilean women. Material and Methods: Thirty women with a body mass index (BMI) > 27 kg/m2 were enrolled to a 4 weeks intervention with a VLCD (using liquid meal replacement). Anthropometric and metabolic parameters were evaluated at baseline and at the end of the intervention. Results: Twenty five women (83 percent) completed the total intervention period. Average weight loss was 5.7 ± 1.5 kg (-6.9 percent of the initial weight) corresponding to a 34.7 ± 13.4 percent of the excess of weight. Significant improvements in triglycerides, total cholesterol and LDL cholesterol (Low Density Lipoproteins) were observed. Insulin resistance determined by Homeostasis model assessment (HOMA), decreased significantly from 3.3 ± 1.8 to 2.0 ± 0.9 (p = 0.003). No serious adverse events were reported. Conclusions: Short term use of VLCDs is safe and effective to induce rapid weight loss in Chilean women.