RESUMEN
Background: The rates of obesity in Mediterranean and Middle East regions are increasing. This may be related to worsening physical inactivity, and gravitation away from more healthful nutrition. Methods: This roundtable discussion includes 4 obesity specialists with experience in the clinical management of obesity. Included in this discussion are citations regarding obesity and populations from the Mediterranean and Middle East regions. Results: Among the most studied nutritional dietary pattern having evidence-based data supporting improved cardiometabolic health is the Mediterranean Diet. Prospective studies such as the PREvención con DIeta MEDiterránea (PREDIMED) study support the cardiometabolic benefits of dietary consumption of plant-based, higher fiber foods having a relatively high proportion of unsaturated fats. Cuisine from the Middle East has both similarities and some differences compared to the Mediterranean Diet. Interim analyses of the PREDIMED-Plus study suggest the Mediterranean Diet plus caloric restriction and physical activity intervention reduces body weight and improves cardiometabolic risk factors. As with any dietary intake, Mediterranean and Middle Eastern food choices and preparation affect their nutritional healthfulness. Conclusion: The panelists of this roundtable discussion describe their practical diagnostic processes and treatment plans for patients with obesity from the Mediterranean Region and Middle East.
RESUMEN
Arthroplasty in patients with elevated body mass index results in increased rates of reoperation, instability, revision, and infection. Preoperative weight loss may reduce the complication rate associated with orthopaedic surgery. In addition to lifestyle modification, anti-obesity medications are available to help patients to reduce their preoperative weight. Currently, there are 6 U.S. Food and Drug Administration (FDA)-approved anti-obesity medications in the United States: phentermine, orlistat, phentermine with topiramate extended release (ER), lorcaserin, sustained release (SR) naltrexone with bupropion, and liraglutide. Anti-obesity medications potentially provide a new way to optimize patients before surgery and to ensure successful recovery postoperatively.