Gert van der Hoek
In Memoriam - Editor, Senior Moderator
Published date: 30 October 2015
Abstract
The successes of interventions to obtain weight loss and prevent relapse are limited. Moreover, comorbidities like type 2 diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia and gout, have so far been treated as separate diseases, although mounting evidence shows that these morbidities are consequences of the failing metabolism due to insulin resistance.
Weight loss, in other words treating obesity, improves comorbidities and improves quality of life. Treatment of obesity and its comorbidities is a multidisciplinary matter. It can be done in primary care. It should be widely recognized that a low carbohydrate diet and exercise are the two main aspects of treatment that lead to the desired result: considerable weight loss and diminishment of comorbidities, visible through improvement of blood parameters and improved quality of life.
Because of the complexity of the diet a large role in management is fit for dietitians, supported by psychologists, physiotherapists and exercise trainers. Family physicians and nurse practioners need to be aware of the important role diet and lifestyle play. In insulin resistance medication is not the preferred treatment; it should be avoided as much as possible.
By accepting this challenge in primary care, health professionals can change the prevalence and consequences of obesity and its comorbidities, thus reducing health care costs considerably. Persons that are insulin resistant may regain their health through these measures. They will always stay insulin resistant to a certain extent, and cannot eat normal quantities of carbohydrates that are commonly used and advised in general dietary guidelines.
LINK TO FULL ARTICLE (PDF)
Abstract
The successes of interventions to obtain weight loss and prevent relapse are limited. Moreover, comorbidities like type 2 diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia and gout, have so far been treated as separate diseases, although mounting evidence shows that these morbidities are consequences of the failing metabolism due to insulin resistance.
Weight loss, in other words treating obesity, improves comorbidities and improves quality of life. Treatment of obesity and its comorbidities is a multidisciplinary matter. It can be done in primary care. It should be widely recognized that a low carbohydrate diet and exercise are the two main aspects of treatment that lead to the desired result: considerable weight loss and diminishment of comorbidities, visible through improvement of blood parameters and improved quality of life.
Because of the complexity of the diet a large role in management is fit for dietitians, supported by psychologists, physiotherapists and exercise trainers. Family physicians and nurse practioners need to be aware of the important role diet and lifestyle play. In insulin resistance medication is not the preferred treatment; it should be avoided as much as possible.
By accepting this challenge in primary care, health professionals can change the prevalence and consequences of obesity and its comorbidities, thus reducing health care costs considerably. Persons that are insulin resistant may regain their health through these measures. They will always stay insulin resistant to a certain extent, and cannot eat normal quantities of carbohydrates that are commonly used and advised in general dietary guidelines.
LINK TO FULL ARTICLE (PDF)