FROM THE EXPERT:

Pr DAVID NOCCA & MAXIME VERBERT

The evolution of our lifestyles has led to an increase in the incidence of obesity in our country in recent years. The latest epidemiological data are alarming: 17% of the French adult population is obese (Body Mass Index >30kg/m²) and almost 1% is massively obese (BMI >40kg/m²).

This phenomenon is very worrying, because obesity is a recognised risk factor in many chronic diseases such as type 2 diabetes, cardiovascular diseases, arterial hypertension (HTA), dyslipidemia, degenerative osteo-articular pathologies, some cancers (breast, endometrium, oesophagus, pancreas, kidney… ), nervous breakdown, infertility, gastro-oesophageal reflux, sleep apnoea syndrome, restrictive respiratory pathologies…

The mortality and morbidity risk is closely linked to being overweight (relative risk = 2.5 for a BMI= 35 kg/ m²). Obesity should therefore be considered as a major public health problem and above all as a real chronic disease.

 

Pr D.NOCCA

Head of Bariatric Surgery department at Montpellier University Hospital,

Founder President of the National League against Obesity,

European Ambassador of the IFSO (International Federation of Surgery on Obesity) – St Eloi Hospital, Montpellier.

Mr M. VERBERT

Physiotherapist

Sport physiotherapist,
Specialized Graduate Certificate (DESS) in Physical Preparation
Osteopath – Pérols

The recent health crisis has also highlighted the impact of obesity on the consequences of certain viral infections. As early as 2008, during the H1N1 virus infection, an excess mortality rate was described for the obese population. The COVID 19 infection that developed in 2020 unfortunately confirmed this risk.

To fight against it, the best treatment for obesity seems to be prevention, which consists of regular physical activity and the respect of simple hygienic and dietary measures. However, the multifactorial causes of obesity unfortunately often take over the implementation of these lifestyle rules and weight gain alters the quality and the life span of patients. When obesity is established, physical activity is not easy. Indeed, we cannot ask a patient weighing 150 kg to go for a 45-minute jog.

THE RESUMPTION OR THE BEGINNING OF PHYSICAL EFFORTS AIMING AT LOSING WEIGHT MUST BE SUPERVISED BY ONE OR SEVERAL HEALTH PROFESSIONALS.

 

For some patients the resumption or the beginning of physical efforts aiming at losing weight must be supervised by one or several health professionals. Physiotherapists have multiple roles in this care :
■ Inform the patient about the risks of obesity;
■ Refer the patient to a specialist doctor if necessary;
■ Set up a physical effort education program based on the physical possibilities and background of the patient;
■ Collaborate with the patient’s multidisciplinary care obesity team;
■ Manage osteo-articular and joint problems often linked to obesity.

Some tools have been developed to facilitate the performance of adapted exercises to the patient’s morphology and to avoid musculoskeletal constraints. The challenge for these tools is to be efficient and functional. Indeed, these deconditioned patients must regain a taste for effort, while feeling the benefits in their daily life as quickly as possible.

Thus the efficiency of the tools is ensured by an ingenious combination of physical and cognitive stimuli (Neuro Physical Training-HUBER®) which allows an increased energy expenditure, but also an increased postural adaptation.

Finally, what is the most important is that this type of training is long-lasting because it allows these initially deconditioned patients to regain a daily physical activity through learning better posture and functional gestures.

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