Abordagem da obesidade em adolescentes atendidos em serviço público de saúde: conceitos, dificuldades e expectativas dos pacientes e seus familiares

Abstract

Obesity in adolescence has risen significantly in the past decades and is recognized as a truly global epidemic. His appearance at this stage of life is related to the risk of persisting onto the adult age and the occurrence of major comorbidities, representing a striking challenge. This study aims to analyze the factors related to the treatment ofobesity in adolescents treated at a public health service in order to contribute to the care provided to patients. This is an Action research carried out at a health care unit of the Municipal Department of Health in Belo Horizonte (MG).The sample of this study were adolescents and their parents, who were taken for a first consultation with the nutritionist at the care unit with a diagnosis of obesity between June 2006 and June 2007. It is a qualitative study that used the focus group for data collection andthe method of content analysis. Fifty eight adolescents aged 10-19 years old were studied. In the majority of the sample was found a family history of obesity, parents low scholarship, a retrospective report of unsuccessful dieting and the habit of eating fast. For half of the patients, be overweight wasnt a bothering factor and most of them were at the initial stage of the Food Behavior Changing Mode to starting treatment. The participants reported feelings of insecurity, powerlessness, frustration and anxiety about the treatment. Many parents also reported feelings of guilt, sadness, anger, pity and compassion with regard to obesity in their children. Teenagers described the difficulties they face with the disease, such as discrimination and social exclusion, loss of self-esteem and difficulties with the clothing. Factors cited as facilitators of treatment were the positive attitude of the adolescent, social support and family and link with the health professional. Among the factors that impede the treatment, were cited dissatisfaction with the conduct oftreatment, binge eating, exposure to an obesogenic environment and conflicting family relationships. Several factors are involved in the etiology and persistence of obesity in adolescents, being necessary to develop specific strategies for them, once they commonly show resistance to possible changes in their food habits. It is important to consider the emotional aspects and the influences from their culture and families whenever the strategies are to be established. It is recommended thatintervention begins early, that the programs of treatment and establish permanent changes that help the families to make small and gradual changes. Very restrictive diets are not advisable. It is required to deepen the potentialities of the interdisciplinary approach and train health workers to the nutritional counseling wondering to improve patients adherence to the treatment.