Primary Care and General Pediatrics

For a long time comorbidities of obesity were far more important and needed treatment even if weight loss was not a treatment goal, preferably with medication. Weight reduction is hardly even mentioned as the primary cause of the majority of the health problems. The denial of the dangerous effects of intra-abdominal fat and over-emphasizing the comorbidities towards patients leads to postponement of treatment, and causes too intensive medical treatment.  This leads to  raising the health care costs to unacceptable levels, medicalization of individuals and denial of the own responsibility of patients for their health, leaving it up to them when to regard their own weight as a problem that should be dealt with. The central problem is insulin resistance which leads to a cascade of health problems. This condition should be diagnosed in primary practice and obesity clinics, to ensure a better tailor-made  treatment for patients. Treatment should start at the earliest stage possible, when comorbidities are still reversible and includes a personalized dietary advice and counseling preferably by a dietitian to tackle insulin resistance. An exercise program is part of the treatment. 

This lecture will be focused on dietary approach and diagnosis of insulin resistance. The right composition of the diet in terms of macronutrients can enhance weight loss and diminish comorbidities. Simple tests as part of the diagnosis can support choice for diet and exercise program. A clear diagnosis helps patients to focus on their health and make the right choices for a healthy future.