A PATIENT WITH INCREASED BODY WEIGHT WHO CONSIDERS HIMSELF HEALTHY, ON OUTPATIENT VISIT

According to WHO forecasts, 60% of the worlds population (3.3 billion people) may be overweight (2.2 billion people) and obese (1.1 billion people) by 2030. Increased body weight and atherogenic dyslipidemia are independent risk factors for chronic non-infectious diseases, which, in turn, lead to premature mortality of the working population. Management of patients with increased body weight requires a complex change in their lifestyle and their consistent and sustained efforts. Taking into account the latest data on the contribution of abdominal obesity, dyslipidemia, fatty hepatosis to the risks for development of cardiovascular diseases, these patients are indicated the earliest therapeutic and preventive outpatient intervention. The success of treatment depends on the degree of motivation, the level of compliance of the patient and regular control throughout life. However, when a patient considers himself healthy, he hopes to solve the arising problems quickly and easily, which is often impossible for objective reasons. In this case, the fundamental attitude of the patient may be crucial in the success of treatment. In the article, a typical clinical case of overweight and of other risk factors for chronic non-infectious diseases at the stage of early clinical manifestations associated with increased risks of multiple comorbidities, is described. But the patient, considering himself quite healthy and the first clinical manifestations insignificant, faced with the necessity of regular medical monitoring and complex life-long intervention, partially follows doctors recommendations and eventually is shying away from solving problems. By focusing on a paternalistic or engineering model of relationships with the doctor, the patient significantly reduces the effectiveness of the earliest control of risk factors for chronic non-infectious diseases. Analyzing the presented clinical case, it is possible to draw attention of specialists to the necessity of rationalization of diagnostic and treatment programs in real outpatient practice.