The Virgen de las Nieves University Hospital offers comprehensive treatment for obesity in a specialized consultation where the most severe cases are addressed. In 2024, the Endocrinology and Nutrition team attended to 279 new patients and conducted over 400 medical review consultations and 683 nursing consultations.
This Tuesday, March 4, marks World Obesity Day, defined by the World Health Organization as the abnormal or excessive accumulation of fat that can be harmful to health. The Granada hospital, in line with the strategic approach of the Ministry of Health and Consumption, advocates for a comprehensive approach to this condition aiming to promote lifestyle changes, incorporating a healthy diet and long-term physical exercise.
The Head of the Endocrinology and Nutrition Department, Martín López de la Torre, added that «these measures may involve pharmacological treatments when necessary, and in some cases, surgical interventions,» although «we consider the Mediterranean diet as the foundation to build upon,» he emphasized.
López de la Torre highlighted that «obesity is a disease, not only due to the direct alterations it causes but also because of its association with other conditions that are consequences or worsen with this pathology,» specifically, «the most significant ones being diabetes mellitus, high blood pressure, lipid abnormalities in the blood, and a predisposition to certain cancers. Additionally, obesity reduces life prospects and quality of life.»
The expert explained that «malnutrition includes both undernutrition and obesity, as well as other partial nutrient disorders. Obese individuals are not only malnourished due to excess adiposity but often suffer from other nutritional issues, sometimes stemming from inadequate diets.»
According to the specialist, «if the affected individual and society do not recognize obesity as a disease, treatment opportunities are missed because patient collaboration and social support are essential.»
MULTIDISCIPLINARY CIRCUIT
Obese patients are referred to the Endocrinology and Nutrition Service from Primary Care, or from another hospital department when another physician deems specific intervention necessary for obesity or one of its associated conditions, typically diabetes mellitus.
Upon arriving at the specialized consultation, a clinical and morphofunctional assessment is conducted, including the determination of different body behaviors and functions, such as adipose tissue and its distribution, muscular tissue and its function, and hydration levels, among others.
Recently, classic anthropometry and dynamometry techniques have been complemented with methods like fat and muscle ultrasound, bioimpedance analysis, and computed tomography (CT). Once assessed, specialists design a therapeutic plan that includes recommendations to improve lifestyle habits based on the Mediterranean diet and physical exercise, with pharmacological support when necessary.
Most of these patients are referred back to Primary Care for follow-up. Cases requiring more intensive treatment are transferred to the severe obesity specialized consultation, led by endocrinologist Piedad Santiago, where the study is expanded with the collaboration of other specialties such as Pulmonology, Radiology, and Psychology, among others.
When bariatric surgery is deemed necessary by the experts, a protocol is initiated that includes monitoring in the severe obesity nursing consultation, coordinated by Yolanda Castillo, where therapeutic advice is provided and patients are prepared for the surgery in collaboration with the General Surgery department, with intensive intervention. During the period leading up to the surgery, they are also evaluated by other specialties like Gastroenterology.
The nurses in this consultation utilize new technologies for patient monitoring through the C4T Education application, a support tool that, via a PDA, includes all process indications and personalized recommendations.
Once the evaluation is concluded, these cases are presented in a multidisciplinary committee involving all medical and surgical specialties, which ultimately decides the intervention carried out by the general surgeons.