Diet Therapy

dietoterapiaMillions of obese individuals are repeatedly on a diet to solve their obesity problems. However, many patients will gain weight quickly when they interrupt their slimming diet. This condition leads to a vicious circle of recurrent diets, having substitute meals and taking slimming capsules. This alternation of weight loss and weight regain is defined with the term ‘yo-yo’ and this makes harder and harder a long-term future slimming because it reduces the basal metabolism rate.

Medicines

farmaciThere are lots of different types of ‘diet pills’ which may be prescribed or not. These drugs usually work in two different ways: some act as an appetite suppressant, others reduce the amount of fat absorbed during the digestive process. Moreover some drugs are prepared at the chemist’s and this is the reason why they are defined Galenic: a number of these medicines can be very dangerous for their cardio-vascular effects (rise in blood-pressure or normal heart rate increase), psychiatrical effects (frequent anxiety disorders and insomnia) finally they could cause gastrointestinal problems too. Several syrups or tablets with a basis of phendimetrazine, chlorazepate, benfluorex) might result in mental and mood disorders, in strong headaches, in hallucinations and in possible serious sexual dysfunctions. These drugs may efficiently help the patient lose weight but they could have negative side effects generating serious physical and psychological damage too. In addition to this, literature shows that long lasting effectiveness of drugs is quite moderate for a long-term weight loss and maintenance. (Padwal R, Li SK, Lau DC. Long-term pharmacotherapy for obesity and overweight. Cochrane Database Syst Rev. 2004;(3).

Intragastric balloon

palloncino intragastricoThe intragastric balloon is a soft silicon balloon filled with a physiological solution or air. It is placed in the stomach aided by an endoscopic procedure and by a gastroscopy performed under sedation. The balloon will remain there for a period of about six months. It is used to fill part of the stomach resulting in a premature feeling of satiety. This procedure not only will help to decrease appetite but also to have rapidly a feeling of satiety though having only eaten a small amount. As there is no malabsorpotion mechanism in action, the weight loss and the duration of the slimming period depend on a correct regime of diet and a regular physical activity. The average weight loss achieved by the patient during the six months of the treatment period keeping the balloon in his stomach is about 2-3 stones.

Early complications:

• Recurrent or permanent abdominal or dorsal pains
• Gastric problems resulting in vomiting and nausea
• A feeling of heaviness in the stomach
• Gastroesophageal reflux

Late complications:

• Intestinal obstruction or esophagea
• Blockage of the transit of food into the stomach
• Lesions that can destroy parts of the mucosa in the digestive system

Indications:

• Presurgical use in super obese people (BMI>40 or >35 with comorbidity) to reduce the risk of surgery
• Use in obese patients (BMI 30-39) with pathologies which constitute health risk and in those who have not gained long lasting weight loss after the failure of any other previous diets
• Use in seriously obese people (BMI>40 or >35 with comorbidity) who cannot undergo bariatric surgery.

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