Este protocolo aborda el manejo inicial de la obesidad mórbida, orientando una intervención de estilo de vida estructurada y basada en evidencia para lograr una reducción de peso significativa y mejorar los resultados metabólicos y cardiovasculares a largo plazo.
Una pérdida de peso del 5–7% del peso corporal inicial es el objetivo principal — umbral a partir del cual la glucemia y los factores de riesgo cardiovascular intermedios mejoran de forma mensurable. El progreso se revisa al menos cada 3 meses durante el manejo activo del peso.
Nutrition, physical activity, and behavioral therapy are recommended for people with type 2 diabetes and overweight or obesity to achieve both weight and health outcome goals.
Interventions including high frequency of counseling (≥16 sessions in 6 months) with focus on nutrition changes, physical activity, and behavioral strategies to achieve a 500–750 kcal/day energy deficit (irrespective of macronutrient composition) should be recommended for weight loss when available.
Use nutritional plans that create an energy deficit, while still following general nutritional guidance, to achieve weight loss.
Weight loss of 5–7% of baseline weight improves glycemia and other intermediate cardiovascular risk factors.
During active weight management treatment, increase monitoring to at least every 3 months.
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