Abordaje del cambio de hábitos alimentarios y estilos de vida en el manejo de sobrepeso y obesidad: consideraciones prácticas

Violeta Moizé, Gemma Peralta

Resumen


Debido a la diversidad de factores que potencialmente contribuyen al desarrollo y mantenimiento del sobrepeso y obesidad, las guías clínicas específicas de tratamiento recomiendan un abordaje terapéutico multidisciplinar en el que intervienen, principalmente, médicos especialistas en endocrinología y nutrición, enfermería, psicólogos y dietistas-nutricionistas. Durante los últimos años, el acelerado aumento de la prevalencia de obesidad y la escasa respuesta al tratamiento convencional a largo plazo provocó un cambio de paradigma en el modelo de tratamiento y la relación terapéutica. Partimos de un modelo terapéutico paternalista y jerarquizado entre médico y paciente a un modelo de decisiones compartidas que tiene como objetivo empoderar al paciente en el control y toma de decisiones de su enfermedad. Este artículo tiene como objetivo revisar y proporcionar algunas de las pautas de manejo que favorecen un enfoque práctico centrado en el paciente y la importancia de potenciar la adhesión de la persona al programa como medida de éxito del tratamiento.
Otro aspecto importante que se recoge en este documento hace referencia al modelo de comunicación entre el terapeuta y el paciente mediante la entrevista motivacional, para generar un proceso favorable al cambio. Para finalizar este primer enfoque, se considerarán brevemente, aspectos relacionados con la adhesión al tratamiento por su estrecha relación con el mantenimiento del peso perdido a largo plazo. Finalmente, y dada la situación de pandemia que estamos viviendo, se consideraran aspectos relevantes que impactan de manera especial a la población a la que hacemos referencia en este artículo.


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