OBESITY: TREATMENT FOR METABOLIC SYNDROME

The treatment for an obese person with metabolic syndrome is weight loss, which reduces insulin resistance and brings about improvements in lipid profile, blood glucose and blood pressure.

Treating such patients with antihypertensives, cholesterol-lowering agents, blood-thinning agents and acetylcholine esterase (ACE) inhibitors without addressing the issue of their weight is an expensive, high-risk strategy that ignores the underlying pathophysiology. Unfortunately, it is extremely common practice. It might be that weight loss in an individual is impossible or insufficient, or that even marked weight loss alone does not completely restore metabolic factors to normal. In these instances, treatment for one or more individual component of the metabolic syndrome, e.g. blood pressure, might be necessary. In other instances, pharmacotherapy might be required as an intermediate measure while weight loss is being accomplished. As a rule, the management of each individual component of the metabolic syndrome is no different to the management of that condition in isolation; that is, the treatment of raised cholesterol is the same, with or without the presence of metabolic syndrome. The exception is that in the treatment of blood pressure, diuretics should be used with caution because of the effects of high circulating insulin on the kidneys, and p-blockers should be avoided if possible because of the chance of weight gain.

The study of metabolic syndrome acts as a clear illustration to clinicians who do not consider treating obesity as essential, or do not believe it is an important chronic medical condition. Regardless of the underlying cause, obesity must be treated as a priority because of the sinister metabolic sequelae.

*12/312/5*