Respuesta al tratamiento farmacológico según el fenotipo de comportamiento alimentario en los pacientes con obesidad
Fecha
2023
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La obesidad es una enfermedad multifactorial con una alta incidencia y prevalencia que
requiere un manejo multidisciplinario. Dentro de su abordaje terapéutico, el
tratamiento farmacológico juega un rol importante, siendo necesaria en la práctica
clínica diaria una herramienta fácil de aplicar para la selección del medicamento ideal
en cada caso.
Objetivo: Identificar la respuesta al tratamiento farmacológico en base al fenotipo de
comportamiento alimentario en los pacientes con obesidad.
Metodología: Se estudiaron prospectivamente 105 pacientes evaluados desde
noviembre de 2022 a noviembre de 2023. Las variables consideradas fueron: índice de
masa corporal, estadio de obesidad por Edmonton Obesity Staging System (EOSS),
presencia de riesgo de depresión, número de comorbilidades asociadas a la obesidad,
fenotipo de comportamiento alimentario en base a la Escala de Fenotipos de
Comportamiento Alimentario (EFCA) Anger-Katz, y porcentaje de pérdida de peso
corporal a los 3 meses. Se dividió la muestra en 2 grupos: A, conformado por los
pacientes a los cuales se les inició el tratamiento en base a su fenotipo de
comportamiento alimentario predominante según el resultado de la EFCA, y el B, a los
cuales se les prescribió un fármaco antiobesidad distinto al sugerido por esta escala. La
información obtenida fue procesada por el programa estadístico SPSS 29.
Resultados: En ambos grupos, la obesidad grado 2 por IMC (40,7% y 41,3%) y estadio
2 por EOSS (55,9% y 67,4%) fueron los de presentación de mayor frecuencia. La
mayoría de pacientes con obesidad presentaron algún grado de riesgo de depresión,
predominando el grado moderado en el grupo A (33,9%), y ligero en el grupo B
XII
(34,8%). Los fenotipos de comportamiento alimentarios más predominantes
determinados por la EFCA Anger-Katz fueron el hiperfágico (31,3 %) y el hedónico
(27,9 %), pero no existieron diferencias entre esta variable y el IMC, estadio por EOSS,
ni número de comorbilidades asociadas a la obesidad. Los pacientes del grupo de
estudio A presentaron una mayor pérdida de peso (5,6 ± 2,2 kg/6,1 ± 2,3 %), en
comparación al grupo B (2,6 ± 1,7 kg/3,0 ± 2,0 %), (p < 0,001).
Conclusiones: Los pacientes a los cuales se les prescribió un fármaco antiobesidad en
base al fenotipo de comportamiento alimentario sugerido por la EFCA Anger-Katz
tendrán un porcentaje mayor de pérdida de peso, lo cual apunta a la necesidad de
abordar el aspecto psicoemocional de los pacientes con obesidad para obtener mejores
resultados
Obesity is a multifactorial disease with high incidence and prevalence that requires multidisciplinary management. Within its therapeutic approach, pharmacological treatment plays an important role, and a simple tool for the daily clinical practice is necessary for selecting the ideal medication for each case. Objective: Identify the response to pharmacological treatment based on the eating behavior phenotype in patients with obesity. Methods: A prospective study of 105 patients evaluated from November 2022 to November 2023 was conducted. Variables considered were: body mass index, obesity stage by the Edmonton Obesity Staging System (EOSS), presence of depression, number of comorbidities associated with obesity, eating behavior phenotype based on the Anger-Katz Eating Behavior Phenotypes Scale (EFCA), and percentage of body weight loss at 3 months. The sample was divided into 2 groups: A, consisting of patients who started treatment based on their predominant eating behavior phenotype according to the EFCA results, and B, those who were prescribed a different anti-obesity drug than suggested by this scale. The information obtained was processed by the SPSS 29 statistical program. Results: In both groups, obesity grade 2 by BMI (40.7% and 41.3%) and stage 2 by EOSS (55.9% and 67.4%) were the most frequent presentations. Most patients with obesity had some degree of risk of depression, with moderate depression predominating in group A (33.9%), and mild in group B (34.8%). The most predominant eating behavior phenotypes determined by the Anger-Katz EFCA were hyperphagic (31.3%) and hedonic (27.9%), but there were no differences between this variable and BMI, EOSS stage, or number of obesity-associated comorbidities. Group A showed greater weight loss (5.6 ± 2.2 kg/6.1 ± 2.3%), compared to group B (2.6 ± 1.7 kg/3.0 ± 2.0%), (p < 0.001). Conclusions: Patients prescribed an anti-obesity drug based on the eating behavior phenotype suggested by the Anger-Katz EFCA will have a higher percentage of weight loss, which points to the need to address the psychoemotional aspect of patients with obesity for better outcomes
Obesity is a multifactorial disease with high incidence and prevalence that requires multidisciplinary management. Within its therapeutic approach, pharmacological treatment plays an important role, and a simple tool for the daily clinical practice is necessary for selecting the ideal medication for each case. Objective: Identify the response to pharmacological treatment based on the eating behavior phenotype in patients with obesity. Methods: A prospective study of 105 patients evaluated from November 2022 to November 2023 was conducted. Variables considered were: body mass index, obesity stage by the Edmonton Obesity Staging System (EOSS), presence of depression, number of comorbidities associated with obesity, eating behavior phenotype based on the Anger-Katz Eating Behavior Phenotypes Scale (EFCA), and percentage of body weight loss at 3 months. The sample was divided into 2 groups: A, consisting of patients who started treatment based on their predominant eating behavior phenotype according to the EFCA results, and B, those who were prescribed a different anti-obesity drug than suggested by this scale. The information obtained was processed by the SPSS 29 statistical program. Results: In both groups, obesity grade 2 by BMI (40.7% and 41.3%) and stage 2 by EOSS (55.9% and 67.4%) were the most frequent presentations. Most patients with obesity had some degree of risk of depression, with moderate depression predominating in group A (33.9%), and mild in group B (34.8%). The most predominant eating behavior phenotypes determined by the Anger-Katz EFCA were hyperphagic (31.3%) and hedonic (27.9%), but there were no differences between this variable and BMI, EOSS stage, or number of obesity-associated comorbidities. Group A showed greater weight loss (5.6 ± 2.2 kg/6.1 ± 2.3%), compared to group B (2.6 ± 1.7 kg/3.0 ± 2.0%), (p < 0.001). Conclusions: Patients prescribed an anti-obesity drug based on the eating behavior phenotype suggested by the Anger-Katz EFCA will have a higher percentage of weight loss, which points to the need to address the psychoemotional aspect of patients with obesity for better outcomes
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DEPRESION, OBESIDAD, DIETA, HOSPITAL GENERAL IESS SANTO DOMINGO, CANTON SANTO DOMINGO DE LOS TSACHILAS, ECUADOR