Fernando Martínez Ubieto: "The pandemic that affects the most people is not the coronavirus but obesity"

Fernando Martínez Ubieto has a Doctor of Medicine from the University of Zaragoza; and a doctor specializing in General Surgery of the Digestive System and an Aragonese specialist in Obesity, who gives some keys to regaining a healthy weight after Christmas.

-What would be a healthy weight?

-When we talk about healthy weight we talk about getting closer to our ideal weight, which is the relationship that weight has with height (weight is divided by the square of height in meters), which would give the body mass index, which does not It must exceed a figure of 25. That would be the healthy weight. When we go over 25, we begin to become overweight and as we advance, various degrees of obesity, until we reach 40 or more, which is when we talk about morbid obesity.

-A few days have passed since Christmas and we have time to become aware of those extra kilos that we have gained. What would be the guidelines to regain pre-holiday weight? And to achieve that healthy weight?
-Well, leaving Christmas with a few extra kilos is something very typical; For a long time in our country we have always celebrated it with gastronomy and it is very easy to gain weight; Just as we have come out of confinement with a few extra kilos and that is very normal. I always recommend that a diet be done by dietitians, nutritionists or endocrinologists, who are the specialists. But if he tells me to recommend diets, I always recommend two; one that Dr. Grande Covián already said, that the best diet is to eat everything on a dessert plate because many times the quantities are what kill us. And the second, we have a very good opportunity which is to turn to the Mediterranean diet, which in our country we have the possibility because it is based on products that are easy to obtain in Spain. It is a diet based on fruits and vegetables, legumes and avoiding sausages and red meats as much as possible; Use white meats such as chicken and rabbit. It is very easy to normalize and lose weight with a well-executed Mediterranean diet. It is a diet to give us an idea, which recommends two servings of vegetables a day, three or four legume dishes a week, three pieces of fruit a day; and dairy products yes but without too much. It is a diet in which one of its protagonists is olive oil, it is a magnificent oil but always in very prudent quantities and do not exceed three or four tablespoons a day. This diet allows you to give yourself joy since it allows you in many cases to have a glass of wine a day. The Mediterranean diet has many advantages, it is very healthy, and it has been shown to reduce the incidence of cardiovascular complications, the incidence of tumors, has antioxidants and reduces inflammatory processes in the body. It is not only healthy for maintaining and losing weight but also for reducing the possible complications that we may have due to various diseases.

-Miracle diets can be harmful to health.
-It is horrible the number of diets that have been coming and disappearing for years. They continually tell us about miracle diets and we have to be very careful. What I have said about the Mediterranean diet could be easy to follow but the best, as I have said, are the diets controlled by dieticians, nutritionists or endocrinologists where they make personalized diets for each case, depending on age, physical activity, The amount of weight you want to lose, there are many factors. Specialists have the ability to choose the best one for each person and these diets require monitoring to see not only how the weight loss is going but also analytical controls so that there is no alteration caused by the diet.

-The Aladino study on Child Nutrition in Spain reveals that 40,6% of children between 6 and 9 years old are above a healthy weight. How do you combat this?
-It is a very important topic. Obesity in Spain is increasing in the adult population but also in the child population. That is due to the dietary changes that have been taking place in recent years. We are forgetting the Mediterranean diet, healthy breakfasts with dairy, fruit and cereals; We are forgetting a healthy and balanced diet and we are changing it for prepared, processed foods... there are many industrial products with many carbohydrates. For a few years now, the WHO has defined obesity as a disease and defines it as the pandemic of the 21st century now that this word is so fashionable due to covid. The pandemic that affects the most people is not the coronavirus but obesity. As a defined disease, prevention and treatment measures are needed, both; Like those who have high blood pressure, diabetes or heart disease, they must be prevented and treated, because otherwise the numbers will get much worse.

-We are not talking about aesthetics, but about health.
-When we talk about obesity we are not talking about aesthetics, we are talking about health; and in certain degrees of obesity there are not only more degrees of complications and when severe obesity rates are reached, life expectancy is no longer the same as that of a normal person. A person with morbid obesity is not going to live the same life as a person at their healthy weight and this has been proven. And furthermore, with Covid it has been shown that the severity of the coronavirus is greater in obese people... the complications are greater, the chances of admission to the ICU are going to be greater and the mortality is going to be greater.

-When would you have to opt for surgery?
-When obesity reaches limits such as severe or morbid obesity, it has been shown that the only effective treatment to reduce the number of kilos and maintain it over time is surgery. There is no other treatment that has as many advantages as surgery in this obesity; advantages in the sense of losing the amount of kilos that need to be lost, which is very high and that this is maintained over time. In these extreme cases, diets are usually insufficient, people get tired before the weight loss we want is achieved and in many cases the rebound effect is very typical. And that is where bariatric surgeons intervene, in these cases of morbid obesity and even more so when it is accompanied by high blood pressure, type 2 diabetes, alterations in cholesterol metabolism, heart disease, etc., etc. It has been shown that obesity can promote hypertension, type 2 diabetes, and also that certain types of tumors, some as common as breast cancer, are more common in people with obesity.