Obesity treatment: recommendation from the Nutrition Branch of the Chilean Society of Pediatrics

Abstract

The treatment of obesity is a multidisciplinary effort that involves the patient, her/his family, different health professionals, and must consider her/his environment. The objectives are to improve nutritional status, reduce excess weight and related complications, as well as to promote the maintenance of healthy lifestyle habits to prevent the development of chronic non-communicable diseases in adults. In this article, we present nutritional interventions, a fundamental part of the treatment, incorporating the patient and her/his family in decision-making and education. Due to the benefits of physical activity, its promotion and reduction of sedentary hours are indications that should always be present, so the type, quantity, intensity, and recommended frequency are described. In relation to psychosocial management, early referral to psychology is suggested in order to investigate psychosocial comorbidities and evaluate the need for psychiatric support and/or treatment. All patients and especially adolescents with obesity may experience lower self-esteem, body image alterations, and dysfunctional eating behaviors, thereby altering their quality of life in several dimensions. Motivational interviewing is used on the basis that the individual her/himself discovers and explores reasons to change and, from this reflection, generates the therapeutic alliances necessary to bring about lifestyle changes. Finally, severe obesity is addressed, which is associated with greater morbidity, deterioration of quality of life, and premature mortality, and therefore requires intensive study and treatment. The creation of care teams would achieve better results.