Obesidad en adultos mayores: abordaje y manejo integral
DOI:
https://doi.org/10.24265/horizmed.2025.v25n3.14Palavras-chave:
Obesidad , Persona Mayor , Sarcopenia , Terapia Farmacológica, Estado FuncionalResumo
La obesidad constituye una pandemia global con graves consecuencias para la salud pública, asociándose directamente con enfermedades vasculares, diabetes, demencia, osteoartritis,
aumento de la mortalidad y discapacidad funcional. En personas mayores, el diagnóstico y el manejo de la obesidad requieren consideraciones específicas que difieren significativamente de los abordajes en poblaciones más jóvenes. La relación entre el envejecimiento y la obesidad es particularmente compleja y multifactorial, compartiendo vías comunes asociadas con enfermedad crónica y procesos inflamatorios sistémicos. Las intervenciones deben centrarse en el individuo, evaluando cuidadosamente el impacto en las capacidades funcionales e intrínsecas, y considerando el tiempo esperado para obtener beneficios terapéuticos. Más allá de los cambios en el índice de masa corporal y el peso, las estrategias terapéuticas deben orientarse principalmente a la disminución de la masa grasa y a la mejora simultánea de la masa muscular y su funcionalidad. Este enfoque resulta más beneficioso que la simple reducción de peso, especialmente al considerar el riesgo de sarcopenia asociado al envejecimiento. Las intervenciones no farmacológicas son las más exitosas y seguras, e incluyen cambios alimentarios, actividad física adaptada y modificaciones del estilo de vida. La edad avanzada no debe considerarse contraindicación para prescribir
intervenciones apropiadas, incluyendo farmacoterapia o procedimientos quirúrgicos en casos seleccionados. El abordaje requiere evaluación individualizada y multidimensional, que considere
aspectos funcionales, cognitivos, emocionales y sociales que influyen tanto en el desarrollo de la
obesidad como en la adherencia y respuesta terapéutica.
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