Birinci Basamakta Obeziteye Klinik Yaklaşım

Öz

Multifaktöryel ve multisistemik bir patogeneze dayanan, birçok hastalıkta risk artışına sebep olan ve önlenebilir ölümlerin önemli nedenlerinden biri olan obezite tüm dünyadaki sağlık sorunlarının başında yer almaktadır. Birinci basamağın temel amaçlarından biri obezite hastalığının gelişmesini engellemektir. Birinci basamak sağlık hizmetleri kapsamında yapılacak olan yaşam tarzı değişikliği, diyet ve egzersiz programları etkin bir mücadale için gerekli müdahalelerden bazılarıdır. Obezite ve obezitenin neden olduğu patolojik tablolar göz önüne alındığında birinci basamak kilit bir noktayı temsil etmektedir. Bu derleme yazımızda birinci basamak sağlık hizmetlerinde obeziteye klinik yaklaşım konusu literatür eşliğinde sunulacaktır.

Anahtar Kelimeler

• Obezite
• birinci basamak sağlık hizmetleri
• klinik yaklaşım

Clinical Approach to Obesity in Primary Care

Öz

Obesity is a multifactorial and multisystemic pathogenic condition that causes an increased risk of many diseases. As one of the major causes of preventable deaths, it also heavily features among the leading health problems worldwide. One of the main purposes of primary care is to prevent the development of obesity disease. Lifestyle changes, diet, and exercise programs to be made within the scope of primary care are some of the necessary interventions for an effective struggle. Primary care is a key point considering obesity and the pathological conditions caused by obesity. This review article presents the existing clinical approach to obesity in primary care.

Anahtar Kelimeler

• Obesity
• primary care
• clinical approach

Kaynakça

1. Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison’s Principles of Internal Medicine; Ed: Kasper DL; 19. Edition; Mc Graw Hill edication; United States 2015; 415e-1, 2, 3.
2. Satman İ, Yumuk VD. Obesity Diagnosis and Treatment Guidelines – TEMD; 3. Edition; Bayt; Ankara 2016; 11-12, 26, 28.
3. Papadakis MA, Mcphee SJ. Current Medical Diagnosis and Treatment; Ed: Rabow MW; 55. Edition; United States; MC Graw Hill education, 2016; 1250-51.
4. Yuen MS, Lui DT, Kaplan LM, et al. A systematic review and evaluation of current evidence reveals 195 obesity-associated disorders (OBAD). Obesity Week. 2016. Poster T-P-3166.
5. Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. JAMA 1999;282(16):1523-1529.
6. Kolotkin RL, Andersen JR. A systematic review of reviews: exploring the relationship between obesity, weight loss, and health-related quality of life. Clin Obes 2017;7(5):273-289.
7. Withrow D, Alter DA. The economic burden of obesity worldwide: a systematic review of the direct costs of obesity. Obese Rev 2011;12(2):131-141.
8. Obesity and Overweight – WHO. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight Accessed: 23.04.2021.

9. Turkish Society of Endocrinology and Metabolism Obesity Diagnosis and Treatment Guide – 2019. BAYT. 2019, Ankara.
10. Kutlutürk F, Öztürk B, Yıldırım B, et al. Obesity prevalence and its association with metabolic risk factors: Tokat province prevalence study. Turkiye Klinikleri J Med Sci 2011; 31:156-63.
11. Aydın Y, Celbek G, Kutlucan A, et al. Obesity Prevalence in West Black Sea Region: The Melen Study. Turk Jem 2012; 16: 52-7.
12. Özcebe H, Bosi ATB, Özkan S, et al. Turkey Childhood (7-8 Years) Obesity Survey (COSI-TUR), 2017. Ministry of Health Publication No: 1080. Ankara, 2017. ISBN: 978-975-590-658-4.
13. Amare AT, Schubert KO, Klingler-Hoffmann M, et al. The genetic overlap between mood disorders and cardiometabolic diseases: a systematic review of genome wide and candidate gene studies. Transl Psychiatry 2017 Jan 24;7(1): e1007.
14. Crujeiras AB, Carreira MC, Cabia B, et al. Leptin resistance in obesity: An epigenetic landscape. Life Sci 2015 Nov 1; 140:57-63.
15. Sharma N, Lee J, Youssef I, et al. Obesity, Cardiovascular Disease and Sleep Disorders: Insights into the Rising Epidemic. J Sleep Disorder Ther 2017; 6(1). pii: 260.
16. Lawlor DA, Smith GD, Ebrahim S. Does the new International Diabetes Federation definition of the metabolic syndrome predict CHD any more strongly than older definitions? Findings from the British Women's Heart and Health Study. Diabetologia 2006; 49: 41.
17. Reaven GM. The metabolic syndrome: is this diagnosis necessary? American Journal of Clinical Nutrition 2006; 83(6): 1237–47.
18. Turkish Society of Endocrinology and Metabolism Dyslipidemia Diagnosis and Treatment Guide – 2019. BAYT. 2019, Ankara.
19. Poobalan AS, Aucott LS, Smith WC, et al. Long-term weight loss effects on all-cause mortality in overweight/obese populations. Obese Rev 2007; 8: 503.
20. Moyer VA. U.S. Preventive Services Task Force. Screening for and management of obesity in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012;157(5):373-378.
21. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiology 2014; 63(25 Pt B):3029-3030.
22. Crawford AG, Cote C, Couto J, et al. Prevalence of obesity, type II diabetes mellitus, hyperlipidemia, and hypertension in the United States: findings from the GE Centricity Electronic Medical Record database. Popul Health Manag 2010;13(3):151-161.
23. Plourde G. Six As model of counseling in obesity. Can Fam Physician 2013; 59(4):353.
24. Kahan SI. Practical Strategies for Engaging Individuals with Obesity in Primary Care. Mayo Clin Proc 2018;93(3):351-359.
25. Dengel DR, Kelly AS, Olson TP, Kaiser DR, Dengel JL, Bank AJ. Effects of weight loss on insulin sensitivity and arterial stiffness in overweight adults. Metabolism 2006; 55: 907–11.
26. Mustajoki P, Pekkarinen T. Very low energy diets in treatment of obesity. Obesity Review 2001; 2: 61-72.
27. Alamuddin N, Wadden TA. Behavioral treatment of the patient with obesity. Endocrinol Metab Clin North Am 2016;45(3):565-80.
28. Rosato V, Temple NJ, La Vecchia C, et al. Mediterranean diet, and cardiovascular disease: a systematic review and meta-analysis of observational studies. Eur J Nutr 2019;58(1):173-191.
29. Estruch R, Ros E, Salas-Salvadó J, et al. PREDIMED study ınvestigators. Primary prevention of cardiovascular disease with a mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med 2018; 21:378(25): e34.
30. Bendall CL, Mayr HL, Opie RS, et al. Central obesity, and the Mediterranean diet: A systematic review of intervention trials. Crit Rev Food Sci Nutr 2018;58(18):3070-3084.
31. Donnelly JE, Blair SN, Jakicic JM, et al. American College of Sports Medicine. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009; 41(2): 459-71.
32. Pate RR. Physical activity and health: dose-response issues. Res Q Exerc Sport 1995; 66: 313-7.
33. Forgione N, Deed G, Kilov G, et al. Managing obesity in primary care: Breaking down the barriers. Adv Ther 2018; 35(2):191-198.