Peut-on affirmer que l’obésité est une maladie chronique qui nécessite un concept thérapeutique individuel et à long terme?
Malheureusement, les programmes créés contre l’obésité sont difficiles à mettre en œuvre et plusieurs personnes ne sont pas à mesure de couvrir les coûts.
Madame Kala,
54 ans, 155 cm 109 kg (IMC 44,2 kg / m²), tension artérielle (RR 145/70 mmHg). Elle veut des conseils et une thérapie pour perdre du poids.
Elle travaille comme infirmière et trouve très peu de temps pour se relaxer. Elle déjeune généralement à la cantine de l’hôpital. Elle ne fait pas de sport faute de temps. Dans l’ensemble, elle ne ressent aucun malaise. A cause de son poids, elle a des difficultés à se mouvoir et à terminer son service à l’heure. Elle est souvent fatiguée et épuisée. Malgré son engagement au travail, il lui arrive d’être frustrée et déprimée. Elle compense se trouble par des fringales multipliées entre sucreries et noisettes.
Après avoir essayé de perdre du poids à plusieurs reprises, elle a effectivement perdu plusieurs kilogrammes et a aussi repris très rapidement le double. Des régimes miracles pourtant…
Dans le cas précis de madame Kala, il serait contre-indiqué de l’associer à un régime quelconque.
Il y a des différentes étapes à traverser:
- Il est recommandé à madame Kala de faire un bilan de santé général pour déterminer tout problème de santé pouvant être présent. Ceci implique un test de risque pour toute prédisposition au diabète. Le processus peut continuer à condition qu’il n’y ait pas de maladie sous-jacente comme cause de l’obésité.
- une adaptation du régime alimentaire,
- organiser des activités physiques
Il est nécessaire avant tout que madame Kala accepte la thérapie, mais surtout qu’elle sache pourquoi elle veut/doit perdre poids. Ceci implique la sensibilisation sur la pathologie, sur les causes et les risques.
Regardons cela point par point dans les prochains épisodes…
DDH
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