Las Dietas Hacen Daño: una Crítica al Paradigma de Salud Centrado en el Peso
Resumen
En los últimos años “el sobrepeso” y “la obesidad” se han posicionado entre los más grandes desafíos para la salud pública del país, a tal grado que se han normalizado frases como la guerra contra la obesidad para hacer alusión a un enemigo en común, al que se debe eliminar. Para tales fines se han instaurado diversas políticas que en lugar de preservar la salud han resultado en medidas violentas que han fomentado el juicio y la estigmatización hacia los cuerpos gordos. Entre las soluciones individuales que han propuesto diferentes instituciones rectoras destacan la dieta y el ejercicio como dos pilares fundamentales en el tratamiento “anti-gordura”. Sin embargo, poco se habla de las repercusiones que tiene el someterse a dietas para bajar de peso y si realmente existe evidencia científica que demuestre que esa puede ser una alternativa sostenible a largo plazo. Este texto busca problematizar la cultura de las dietas con una lectura diferente al enfoque tradicional de salud centrado en el peso, con la esperanza de contribuir con un cambio de paradigma en la ciencia de la nutrición que evite que más personas en la búsqueda de delgadez terminen perdiendo su salud.
Palabras clave:
Dietas, daños, salud, peso.
Texto completo:
Referencias
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Sala-Pons V, Drobnic-Martínez F, Pons-Biescas A. Restricción calórica, un método eficaz, sencillo y saludable para perder peso. Nutr Clínica y Dietética Hosp [Internet]. 2018 [cited 2023 Oct 31];37(4):77– 86. [En linea] https://revista.nutricion.org/PDF/PONSSALA.pdf
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Schulz M, Liese AD, Boeing H, Cunningham JE, Moore CG, Kroke A. Associations of short-term weight changes and weight cycling with incidence of essential hypertension in the EPIC-Potsdam Study. J Hum Hypertens [Internet]. 2005 Jan [cited 2023 Sep 15];19(1):61–7. [En linea] https://pubmed.ncbi.nlm.nih.gov/15343355/
Contreras A ML, Morán K J, Frez H S, Lagos O C, Marín F MP, Pinto B M de los Á, et al. Conductas de control de peso en mujeres adolescentes dietantes y su relación con insatisfacción corporal y obsesión por la delgadez. Rev Chil pediatría [Internet]. 2015 [cited 2023 Sep 20];86(2):97–102. [En linea] http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062015000200006&lng=es&nrm=iso&tlng=es
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Aguilera C, Labbé T, Busquets J, Venegas P, Neira C, Valenzuela Á, et al. Obesidad: ¿Factor de riesgo o enfermedad? Rev Med Chil [Internet]. 2019 [cited 2023 Sep 15];147(4):470–4. [En linea] http://www.scielo.cl/scielo.phpscript=sci_arttext&pid=S0034-98872019000400470&lng=es&nrm=iso&tlng=es
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Jiménez-Cruz A, Bacardí-Gascón M. ¿Es Sano Perder Peso? Rev Salud Publica [Internet]. 2009;11(5):802–10. [En linea] http://www.scielo.org.co/pdf/rsap/v11n5/v11n5a13.pdf
Sala-Pons V, Drobnic-Martínez F, Pons-Biescas A. Restricción calórica, un método eficaz, sencillo y saludable para perder peso. Nutr Clínica y Dietética Hosp [Internet]. 2018 [cited 2023 Oct 31];37(4):77– 86. [En linea] https://revista.nutricion.org/PDF/PONSSALA.pdf
Gaesser G. Is “Permanent Weight Loss” an Oxymoron? In: Rothblum E, Solovay S, editors. The Fat Studies Reader. New York University Press;2009. p. 37–41.
Fischer M, Oberänder N, Weimann A. Four main barriers to weight loss maintenance? A quantitative analysis of difficulties experienced by obese patients after successful weight reduction. Eur J Clin Nutr [Internet]. 2020 Aug 1 [cited 2023 Sep 20];74(8):1192–200. [En linea] https://pubmed.ncbi.nlm.nih.gov/32001814/
O’Hara L, Taylor J. What’s Wrong With the ‘War on Obesity’? A Narrative Review of the Weight-Centered Health Paradigm and Development of the 3C Framework to Build Critical Competency for a Paradigm Shift. SAGE Open. 2018;8(2).
Camacho AL. Determinantes del sobrepeso: Biología, psicología y ambiente. Rev Endocrinol y Nutr. 2005;13(4):197–202.
Leibel RL, Rosenbaum M, Hirsch J. Changes in Energy Expenditure Resulting from Altered Body Weight. https://doi.org/101056/NEJM199503093321001 [Internet]. 1995 Mar 9 [cited 2023 Sep 15];332(10):621–8. [En linea] https://www.nejm.org/doi/full/10.1056/nejm199503093321001
Ganipisetti VM, Bollimunta P. Obesity and Set-Point Theory. StatPearls [Internet]. 2023 Apr 25 [cited 2023 Nov 10]; [En linea] https://www.ncbi.nlm.nih.gov/books/NBK592402/
Ochner CN, Barrios DM, Lee CD, Pi-Sunyer FX. Biological mechanisms that promote weight regain following weight loss in obese humans. Physiol Behav [Internet]. 2013 Aug 5 [cited 2023 Nov 11];120:106–13. [En linea] https://pubmed.ncbi.nlm.nih.gov/23911805/
Aphramor L. Validity of claims made in weight management research: A narrative review of dietetic articles. Nutr J [Internet]. 2010 Jul 20 [cited 2023 Sep 15];9(1):1–9. [En linea] https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-30
Applebaum M. Why Diets Fail — Expert Diet Advice as a Cause of Diet Advice as a Cause of Diet Failure.Am Psychol. 2008;(April):2000–2
Neumark-Sztainer D, Wall M, Haines J, Story M, Eisenberg ME. Why Does Dieting Predict Weight Gain in Adolescents? Findings from Project EAT-II: A 5-Year Longitudinal Study. J Am Diet Assoc. 2007 Mar;107(3):448–55.
Neumark-Sztainer D, Wall M, Story M, Standish AR. Dieting and unhealthy weight control behaviors during adolescence: associations with 10-year changes in body mass index. J Adolesc Health [Internet]. 2012 Jan [cited 2023 Sep 15];50(1):80–6. [En linea] https://pubmed.ncbi.nlm.nih.gov/22188838/
Lowe MR, Annunziato RA, Markowitz JT, Didie E, Bellace DL, Riddell L, et al. Multiple types of dieting prospectively predict weight gain during the freshman year of college. Appetite [Internet]. 2006 Jul [cited 2023 Sep 21];47(1):83–90. [En linea] https://pubmed.ncbi.nlm.nih.gov/16650913/
Tomiyama AJ, Ahlstrom B, Mann T. Long-term Effects of Dieting: Is Weight Loss Related to Health? Soc Personal Psychol Compass [Internet]. 2013 Dec 1 [cited 2023 Sep 21];7(12):861–77. [En linea] https://onlinelibrary.wiley.com/doi/full/10.1111/spc3.12076
Schulz M, Liese AD, Boeing H, Cunningham JE, Moore CG, Kroke A. Associations of short-term weight changes and weight cycling with incidence of essential hypertension in the EPIC-Potsdam Study. J Hum Hypertens [Internet]. 2005 Jan [cited 2023 Sep 15];19(1):61–7. [En linea] https://pubmed.ncbi.nlm.nih.gov/15343355/
Contreras A ML, Morán K J, Frez H S, Lagos O C, Marín F MP, Pinto B M de los Á, et al. Conductas de control de peso en mujeres adolescentes dietantes y su relación con insatisfacción corporal y obsesión por la delgadez. Rev Chil pediatría [Internet]. 2015 [cited 2023 Sep 20];86(2):97–102. [En linea] http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062015000200006&lng=es&nrm=iso&tlng=es
Borja BB, Rodríguez FH. La estigmatización del cuerpo obeso: percepción en un grupo de adolescentes mexicanos. Arch en Med Fam [Internet]. 2012 [cited 2023 Sep 20];14(1):21–7. [En linea] https://www.redalyc.org/articulo.oa?id=50730962004
Park K, Hwang H, Cho K, Han K. Body Weight Fluctuation as a Risk Factor for Type 2 Diabetes: Results from a Nationwide Cohort Study. J Clin Med. 2019;8(950):11 p.
Wannamethee SG, Shaper AG, Walker M. Weight Change, Weight Fluctuation, and Mortality. Arch Intern Med. 2002;162:2575–80.
Bangalore S, Fayyad R, Laskey R, DeMicco DA, Messerli FH, Waters DD. Body-Weight Fluctuations and Outcomes in Coronary Disease. N Engl J Med. 2017 Apr 6;376(14):1332–40.
Burton BT, Foster WR, Hirsch J, Van Itallie TB. Health indications of obesity: An NIH consensus development conference. Int J Obes.1985;9(3):155–70.
Bacon L, Aphramor L. Ciencia del Peso : Evaluando la Evidencia para un Cambio de Paradigma. Nutr J [Internet]. 2011;10(9):1–13. [En linea] http://www.nutritionj.com/content/10/1/9%0A
Costa-Gil JE, Spinedi E. La tormentosa relación entre las grasas y el desarrollo de la diabetes mellitus de tipo 2: actualizado. Endocrinol y Metab [Internet]. 2017;4(3):109–23. [En linea] http://dx.doi.org/10.1016/j.raem.2017.06.001
Aguilera C, Labbé T, Busquets J, Venegas P, Neira C, Valenzuela Á, et al. Obesidad: ¿Factor de riesgo o enfermedad? Rev Med Chil [Internet]. 2019 [cited 2023 Sep 15];147(4):470–4. [En linea] http://www.scielo.cl/scielo.phpscript=sci_arttext&pid=S0034-98872019000400470&lng=es&nrm=iso&tlng=es
Sánchez Martínez B, Vega Falcón V, Gómez Martínez N, Vilema Vizuete GE. Estudio de casos y controles sobre factores de riesgo de diabetes mellitus tipo 2 en adultos mayores. Rev Univ y Soc. 2020;12(4):156–64.
Griera Borrás JL, Contreras Gilbert J. ¿Existe el obeso sano? Endocrinol y Nutr [Internet]. 2014 Jan 1 [cited 2023 Oct 29];61(1):47–51. A[En linea] https://www.elsevier.es/es-revista-endocrinologia-nutricion-12-articulo-existe-el-obeso-sano-S157509221300140X
Prost M, Martínez R. El costo de la doble carga de la malnutrición. Impacto social y económico en Chile, Ecuador y México [Internet]. 2017. [En linea] https://docs.wfp.org/api/d o c u m e n t s / W F P - 0 0 0 0 1 1 0 3 7 1 / d o w n l o a d / ? _ ga=2.145938807.219777263.1576508276-979544760.1497470639
Carretero M. Tratamiento de la obesidad.Offarm [Internet]. 2002 Mar 1 [cited 2021 May12];21(3):128–31. [En linea] http://www.elsevier.es/es-revista-offarm-4-articulo-tratamientoobesidad-13028003
Rivera J, Colchero M, Fuentes M, González T, Salinas C, Hernández G, et al. La Obesidad en México. Estado de la política pública y recomendaciones para su prevención y control. La obesidad en México: Estado de la polìtica pública y recomendaciones para su prevención y control.2018. 190–200 p.
Instituto Mexicano del Seguro Social. Diagnóstico y tratamiento del sobrepeso y obesidad exógena [Internet]. México; 2018 [cited 2023 Nov 8]. [En linea] http://imss.gob.mx/profesionales-salud/gpc
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