In women, for example, the polycystic ovary is the main culprit. However, periodic assessment of the thyroid is still important, especially in older ages, as well as close and comprehensive monitoring, together with an adequate diet and physical exercise plan.
People often associate obesity with hypothyroidism, however, this association may not exist, however, it is important to perform hormonal tests to measure thyroid function (TSH and free T4), although nonspecific signs and symptoms of hypothyroidism may not exist. hypothyroidism, leading to being underdiagnosed.
However, there may be an indirect association between both conditions. A person suffering from hypothyroidism feels tired and a tired person moves less and exercises less or not at all. In this way, hypothyroidism is an indirect factor in weight gain because, less exercise, fewer calories are burned. Also, hypothyroidism causes a decreased metabolism and therefore the body uses less energy. Also, hypothyroidism can cause depression and this also contributes to obesity. A person who is depressed moves less, is less active, and sometimes, especially if the person is overweight, has a greater appetite.
In this way, physical exercise is currently considered the therapeutic weapon for patients with these two already established diseases, since physical exercise is more relevant in controlling obesity, and pharmacotherapy is the great ally of hypothyroidism. However, physical exercise remains a therapeutic measure that is not prescribed by doctors. This is mainly due to the lack of knowledge of its importance in general health as well as in certain specific pathological conditions, but above all to the lack of knowledge of its parameters, such as type of exercises, intensity/load, repetitions, number of sessions, etc.
On the other hand, it is important for doctors to be aware of muscle pain and arthralgia, common symptoms of hypothyroidism that can affect the patient’s reluctance to do any type of physical activity. Physicians must break the cycle; pain-inactivity – deconditioning-pain.
The conclusion reached is that in the face of obesity, regardless of its origin or causes, nutrition and exercise should always intervene, even if the exercise is mild. As for food, regardless of the diet chosen (and there are always many available), reducing calories is essential.
Obese patients who have lost weight and also suffer from hypothyroidism, follow-up is necessary. It must be remembered that exercise and calorie reduction must be maintained so that the patient does not gain weight again (around 80% of patients who discontinue nutritional monitoring return to their previous weight within a year). There is also a need to monitor thyroid function and measure values that may need to be adjusted as the thyroid is a very sensitive organ. In fact, it is the “dictator” of our metabolism.
Finally, it must be remembered that an obese person is always a complex patient with multiple comorbidities such as diabetes, hypertension, dyslipidemia, gastroesophageal reflux, osteoarticular problems, increased risk of multiple cancers, and multiple cardiovascular complications, so follow-up should also be structured systematically by a multidisciplinary team.
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