OBESITY: Medication and surgery, the options you shouldn’t overlook

“Weight loss achieved through dietary changes and increased physical activity are cornerstones of treatment for overweight hypertension. However, these behaviors are rarely sustained over the long term. Thus, the first reductions in blood pressure obtained are not sustained over time, ”explains Dr. Michael E. Hall, director of the Department of Cardiovascular Diseases at the University of Mississippi.

This new scientific statement suggests that pharmacological and surgical strategies can contribute to both weight reduction and long-term lowering of blood pressure – which does not exclude opting for a healthy diet for the heart and the practice of a physical activity.

Reduce high blood pressure linked to obesity,

this is the aim of these new guidelines, the authors of which have reviewed previously published research.

The impact of diet and physical activity is obviously not questioned:

a healthy diet allows better control of weight and blood pressure. However, the new guidelines focus on eating habits rather than individual foods and nutrients. Thus, the Mediterranean diet is once again in the spotlight and just like the DASH diet for the control of hypertension. This involves emphasizing the consumption of fruits, vegetables, legumes, nuts and seeds with moderate amounts of fish, seafood, poultry and dairy products, and low amounts of red and processed meats and sweets.

“Eating healthy foods has beneficial effects on weight and blood pressure,

While many weight loss diets bring short-term results, eating “healthy and balanced” consistently and over the long term helps maintain weight loss or a healthy weight “.

Intermittent fasting, which alternates between eating and fasting times during the day or week, also allows some reduction in weight and blood pressure, especially in people with metabolic syndrome (high blood sugar, low cholesterol levels HDL, high triglycerides, high blood pressure and waist circumference). However, in the longer term, intermittent fasting appears to have little impact on blood pressure control.

Regular physical activity as well as improving cardiovascular fitness and reducing sedentary time can also help reduce body weight and blood pressure, also confirms this new scientific statement from the AHA.

What if lifestyle changes have failed to reduce weight and control blood pressure?

Prescription drugs may be considered for people who are obese or overweight and have a co-morbid condition of obesity, such as hypertension. “The use of drugs or weight loss surgery remains rare before the development of target organ damage. Yet, combined with lifestyle changes, these 2 options can be effective in the long run.

Medicines called GLP-1 receptor agonists have been shown to help sustain weight loss and significantly reduce blood pressure. GLP-1 agonists, such as liraglutide and semaglutide, are synthetic hormones, self-administered as a daily or weekly injection, that reduce appetite and help people feel full.

Bariatric surgery, long-term effective for weight loss and blood pressure control: gastric bypass surgery can promote weight loss in people with severe obesity (BMI> 35 or even 40 or more) and also reduce blood pressure ‘hypertension. Analysis shows that bariatric surgery can “resolve” hypertension in 63% of operated patients. In addition, these surgeries have progressed considerably and are becoming less invasive and less risky.

The statement finally puts gaps in research on the use of drugs and surgery to prevent and treat obesity-related hypertension, especially in patients with kidney disease or heart failure.

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