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Intervenciones de pérdida de peso conductual para prevenir la morbilidad y la mortalidad relacionadas con la obesidad
, Susan J Curry1, Alex H Krist2,3
1University of Iowa, Iowa City.
JAMA
|October 17, 2018
Resumen
Las intervenciones conductuales intensivas para la obesidad ofrecen beneficios moderados para la pérdida de peso y la prevención de la diabetes tipo 2 en adultos. Estas estrategias se recomiendan para adultos con un índice de masa corporal de 30 o más.
Área de la Ciencia:
- Medicina de prevención de la enfermedad
- Salud pública
- Intervención clínica
Sus antecedentes:
- La obesidad afecta a más del 35% de los hombres y el 40% de las mujeres en los Estados Unidos.
- La obesidad está relacionada con problemas de salud graves como enfermedades cardíacas, diabetes tipo 2, cáncer y aumento del riesgo de mortalidad.
- Las recomendaciones actuales para el cribado de la obesidad y la intervención requieren una actualización.
Objetivo del estudio:
- Actualizar la recomendación de 2012 del Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF, por sus siglas en inglés) sobre el cribado de la obesidad en adultos.
- Revisar la evidencia sobre las intervenciones de pérdida de peso y mantenimiento adecuadas para los entornos de atención primaria.
Principales métodos:
- El USPSTF revisó la evidencia sobre las intervenciones conductuales y farmacoterapéuticas para el control de peso.
- Las intervenciones consideradas fueron las que se podían entregar o referir desde la atención primaria.
- Las intervenciones quirúrgicas y basadas en dispositivos fueron excluidas de esta revisión.
Principales resultados:
- Las intervenciones conductuales intensivas y multicomponentes muestran beneficios moderados para la pérdida de peso y la reducción de la incidencia de diabetes tipo 2 en adultos con obesidad.
- Las intervenciones de mantenimiento de la pérdida de peso basadas en el comportamiento también proporcionan beneficios moderados.
- Los daños asociados con estas intervenciones de comportamiento son mínimos o nulos.
Conclusiones:
- El USPSTF recomienda ofrecer o derivar a adultos con obesidad (IMC ≥ 30) a intervenciones conductuales intensivas.
- Estas intervenciones proporcionan un beneficio neto moderado para los adultos con obesidad.
- También se apoyan las estrategias de mantenimiento de la pérdida de peso basadas en el comportamiento.
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