Perimenopausal obesity and how to approach it
Authors:
P. Šrámková
Authors‘ workplace:
OB klinika Praha, Endokrinologický ústav Praha
Published in:
Prakt Gyn 2010; 14(1): 42-47
Category:
Review Article
Overview
The prevalence of overweight and obesity has reached pandemic proportions. Obesity is caused by the imbalance between energy intake and expenditure, on a significant genetic background. The prevalence of overweight in perimenopausal population is 66 %, out of which 35 % of women are obese. During perimenopause, the physiological energy intake requirement is 1/ 3 lower than at 25 years of age, however, women generally do not decrease their portions, continue with traditional Czech cuisine rich in fats, many women start comfort eating. Other contributing factor is a lack of exercise. The cause of perimenopause is physiological hormonal changes which can lead to the development of metabolic syndrome – the key risk factor of cardiovascular disease. The risk is increased 4- fold [6– 7]. Treatment of obesity in perimenopause is more difficult and the achieved weight loss is smaller than in younger women. Oftentimes we are satisfied with just weight maintenance. The goal is to reduce weight by 5– 10 %. This is achieved with lifestyle change, including diet and exercise modifications. We also use effective pharmacotherapy- sibutramine and orlistat- whilst respecting their contraindications. Bariatric surgery is indicated for patients with BMI ≥ 35 and comorbidities, or BMI ≥ 40, under the age of 65. Its efficacy is high, over 80 % of patients achieve weight reduction of 15– 25 % and more of initial weight. Long term efficacy in Loir weight maintenance is also documented, as well as improvement or disappearance of concomitant diseases, reduction in medication and increased life expectancy.
Key words:
obesity – toxic environment – waist circumference – obesity treatment – weight– loss diet – pharmacotherapy – exercise – psychotherapy – bariatric surgery
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