2023-11-24 09:54:24
by Elena Meli
Different molecules with different properties for medicines: a specialist is needed. For surgery in Italy there are few places, in any case not a cosmetic operation: after the operation you must commit to a precise program
Losing weight is the goal, but how can we achieve it given that obesity is a complex disease and it’s not enough to go on a diet and move more to resolve it? Today, in addition to surgery, which should be reserved for the most serious cases (see below, ed.), good results can also be achieved with drugs, replies Luca Busetto, president of the Italian Obesity Society. Anti-obesity drugs of the past created problems because they acted on generic systems and neurotransmitters involved in many functions, such as serotonin and dopamine; new drugs have different and more specific mechanisms and are therefore safer and more effective.
Drugs
Today in Italy for obesity the doctor can prescribe orlistat, which prevents the intestinal absorption of fats, the naltrexone-bupropion combination which acts on the appetite regulating centres, and liraglutide, an antidiabetic which in addition to normalizing blood sugar levels, reduces the of hunger and helps you lose weight.
The double thread between obesity and diabetes is well established and this is demonstrated by semaglutide, an antidiabetic relative of liraglutide, which is even more effective for losing weight: in adults, up to 20% of weight can be lost and the result is maintained as long as the treatment is followed. Approved against obesity by the European Medicines Agency at a higher dosage than that used in type 2 diabetes, it is not yet available in Italy with this indication and can be prescribed to those with type 2 diabetes, but it has become a case because in the USA even simply overweight people have started using it to lose weight: this, in addition to exposing them to greater side effects and risks, has created a shortage of supply for patients with indications for use. Those who do not have diabetes or obesity should not use semaglutide, but in these two diseases there is also a reduction in cardiovascular risk, adds Fabrizio Oliva, president of Anmco. More drugs are on the way concludes Busetto. Obesity treatment could change a lot in the coming years, if fair access to these medicines is guaranteed.
Surgery
In Italy there are at least 600 thousand obese people who are indicated for bariatric surgery, but only 20-30 thousand operations are performed every year. There are approximately 130 obesity treatment centers from which one can enter the therapy process that can lead to the operation, but it is necessary to increase the possibilities of access and overcome the significant regional differences, given that 55 percent One hundred of the interventions are concentrated in the Northern Regions of the country, where the prevalence of obesity is lower.
The experts explained it during the last congress of the Italian Society of Surgery for Obesity and Metabolic Diseases (Sicob): bariatric surgery has precise indications and is reserved for serious cases, in which it can reduce weight by up to 70 percent. excess and has a low complication rate. The data presented show that it also has a positive impact on patient mortality, which in general is reduced by 16 percent compared to untreated obese people.
Not a cosmetic operation
Yet even about this surgery there are some misunderstandings because, as explained by Marco Antonio Zappa, president of Sicob, it is often still considered an aesthetic operation to satisfy the whims of people “guilty” of being obese, without understanding that it is instead a life-saving operation against a disease that has been defined by some as the cancer of the third millennium: if obesity didn’t exist we would have 12-13 percent fewer tumors. But if we continue to consider it only an aesthetic problem for which the patient is responsible, we will not be able to solve it.
Even surgery, which is increasingly less invasive and more effective, should not be considered an easy solution because, as Zappa further specifies, it represents a crucial step that reduces the risk of stroke, diabetes, coronary heart disease and even some tumors but after the operating room it is necessary to commit and be followed by the doctors of the Centers, because if you believe you can do it on your own there is a real danger of regaining the lost weight.
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November 24, 2023 (modified November 24, 2023 | 08:54)
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