A obesidade é considerada uma doença crônica e precisa ser combatida através de atendimento clínico e psicológico
Os dados são alarmantes e as consequências, graves. Há uma tendência mundial de crescimento do número de pessoas obesas. No Brasil, 40% da população está na faixa da obesidade ou de sobrepeso. “A diferença entre ter sobrepeso e ser obeso é relacionada justamente ao risco maior de se ter problemas graves, relacionados a essa condição. E são muitas as complicações que podem surgir. Quem é obeso tem uma probabilidade maior de desenvolver doenças cardíacas, alguns cânceres, doenças articulares, apneia do sono (obstrução das vias aéreas), diabetes e doenças inflamatórias. Pesquisas indicam que mulheres obesas têm probabilidade maior de desenvolver o câncer de mama ou quadro de incontinência urinária, principalmente no período pós-menopausa”, explica a doutora Maria Celeste Osório Wender, professora titular de ginecologia da Universidade Federal do Rio Grande do Sul.
Os fatores que causam a obesidade também são vários. “Temos a questão genética, é preciso conferir o histórico familiar, se existem casos de obesidade na família. É sabido que se houverem casos como esse no âmbito familiar, será mais provável desenvolver a obesidade. E temos também as questões ambientais, como hábitos alimentares ruins, sedentarismo e o metabolismo. Com relação a esse último, vale dizer que quanto mais rápido ele for, melhor, por gastar mais energia, mais calorias. Essa é outra desvantagem que a mulher carrega, porque o homem tem mais músculos, tecidos que consomem muita energia e que ajudam na questão metabólica”, diz Maria Celeste.
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Para a doutora Maria Celeste “o médico, seja ele um clínico geral, um endocrinologista ou um ginecologista, é a pessoa indicada para abordar o assunto. É preciso entender os hábitos alimentares da pessoa e reeducá-la nesse sentido. Aqui a participação de um nutrólogo também é essencial, porque cada caso tem suas particularidades. Em todos os aspectos da obesidade o princípio é o mesmo: os ganhos acontecem gradativamente, sem sobressaltos.
De nada adianta impor uma dieta extremamente rigorosa para quem tem o hábito de comer muito, ela não vai conseguir cumprir os objetivos. Bom senso e equilíbrio são as palavras de ordem. Então tudo tem que ser feito com calma, estabelecendo-se metas possíveis de serem conquistadas, progressivamente”, afirma a doutora.
Outro fator fundamental é a prática de atividades esportivas, que auxiliam no metabolismo. “O ideal é que a pessoa pratique 150 minutos semanais de atividades aeróbicas (caminhadas, corridas leves, pedalar, nadar) combinada com duas a três sessões de musculação, na mesma semana. Se a reeducação alimentar combinada com a prática esportiva não der resultados satisfatórios, podemos recorrer ao uso de medicamentos, que na sua essência são moderadores de apetite. Em último caso, temos a possibilidade da cirurgia bariátrica (redução do estômago), mas existem regras para sua realização. O que posso afirmar é que essa cirurgia evoluiu muito e hoje apresenta riscos menores”, explica Maria Celeste.
A doutora chama a atenção para outro fator importante, o corpo pode tornar-se seu próprio inimigo durante o tratamento. “O que acontece é que ao se reduzir o peso, o organismo reage para voltar ao status original. Isso ocorre por meio do aumento da grelina, hormônio que estimula o apetite. Então, além de todos os obstáculos já citados, é preciso enfrentar mais essa condição, de sentir fome e ter que se controlar, que pode sim aparecer durante a luta de ter que perder peso devido a obesidade”.
Saúde Mental
A condição da pessoa obesa traz outras complicações, podendo afetar a saúde mental do paciente. “A sociedade, de certa forma, condena o obeso. Isso pode desenvolver aspectos negativos como carregar dentro de si um sentimento de culpa, ansiedade excessiva ou ainda sofrer com um quadro depressivo, especialmente para quem é vítima do bullying. Essas condições podem pôr tudo a perder, fazer com que o paciente coma ainda mais, quando o necessário é justamente o inverso. A ajuda de médicos psiquiatras ou psicólogos pode ser relevante em alguns casos. É muito importante que a classe médica tenha consciência com relação ao tema; pessoas obesas precisam de ajuda. E, claro, o apoio de familiares e amigos nessa batalha também é requisitado. Evitar comparações e cobranças excessivas é recomendado, para que se minimize a possibilidade de frustração e o insucesso do tratamento”, finaliza a doutora.
Serviço
- O Sistema Único de Saúde (SUS) oferece tratamento para a obesidade e ainda a possibilidade da operação bariátrica, desde que o paciente atenda os requisitos clínicos desejados. Para mais informações ligue para o ‘Disque Saúde’ através do número 136.
- O Hospital das Clínicas de São Paulo tem ambulatório exclusivo para tratamento da obesidade, mas o caminho para ser atendido no HC também é pelo SUS.
- Outro centro reconhecido no tratamento da obesidade, voltado para crianças e adolescentes, é o ambulatório da Unicamp, em Campinas (SP). Para mais informações acesse https://hc.unicamp.br/.
- Pessoas que possuem planos de saúde privados devem consultar sua rede credenciada para solicitar uma avaliação clínica pertinente e que ofereça serviços sobre obesidade.
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