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O SISTEMA #06 | O país do sobrepeso

O SISTEMA #06 | O país do sobrepeso

I get really distressed about this waiting. Is this surgery really happening? I used to eat a whole roasted chicken by myself. I’d do anything for a candy. 5 to 10% of Brazilians have a formal indication for bariatric surgery. In Brazil, today, we have more obese than undernourished people.

The malnutrition was replaced by bad nutrition. Obesity is a package which brings high blood pressure, diabetes, rheumatologic and orthopedic problems, cardiovascular diseases and even cancer. People gain weight, reach the overweight range and, when they least expect, they are obese. The System A portrayal of healthcare in Brazil How was your week, guys?

Did you eat better? -A little bit? -A little bit more, because I went to parties during the week, birthday parties… So I ate a little bit more. Being overweight is the first red flag to inform us that we are consuming more food than our organism is needing.

Brazil is one of the countries with the higher numbers of overweight and obese people. The main reason for the corporal mass increase is our current lifestyle. It’s a more sedentary life, a lower energetic spent. I’m here at Ipiranga, a neighborhood of São Paulo, in a region known as “old mill”.

I came to meet Mrs. Teresa and her daughter, Luciana. Mrs. Teresa has been suffering with diabetes for many years, and her daughter keeps prohibiting her to eat candies and telling her to control her blood sugar levels. Luciana, you father had diabetes. How did you react when you’ve been told

Your mom had the same problem? I got scared. Because we think: “I’ll be having it, too.” Three kids, I’m the older. So, I always get worried. Everything was right, here at home, and after many years, my mom was diagnosed with diabetes. So we got a little scared. -What are Mrs. Teresinha’s… -Indulgences?

She loves eating candy. -Yeah? -She is crazy about candies. I always loved candies. I’d do anything for candy. Do you know what the problem is, Teresinha? The blood glucose levels rise and we don’t even notice. There’s no symptom. It will only have a symptom when it’s too high.

When the blood sugar levels are increased, that blood with high sugar levels will be bad for the whole body. It will increase the chances of a heart attack. The chances of a brain stroke. Because those vessels are more likely to be blocked by a clot.

Vessels of the legs will be blocked more frequently, for example. That’s why there’s so much cases of amputation on people with diabetes. We are living a worldwide obesity epidemic and Brazil is a part of it. Here, 32% of adults are at an overweight range and 20% are obese.

We’ll be talking about this problem with the couple who has been living with the consequences of obesity. Andreia and Armando. Armando, when did you start to gain weight? In fact, I was always fat, since I was a kid. I fed myself badly. I used to eat about three kilos per meal.

I used to eat a whole roasted chicken by myself. A two liter soda bottle, I used to drink it all alone. When I was 20 years old, I was weighing over 100 kilos. -Living a sedentary life. -Absolutely. In 2009, I had my first blackout. I crashed my car, and I don’t remember anything…

I was over 200 kilos by then. -Could you lay down and sleep? -I could only sleep while seated. -And snored a lot. -Which was the highest weight -you reached? -261 kilos. It’s a bad obesity range. You lost about 70kg to be in conditions to have surgery.

-To be able to have surgery. -Within two years? -Five years. -Five years, 70 kilos. After that, you lost 60 more within two years. -How much do you weigh today? -127 kilos. Explain to me what is dumping. -Dumping… -Something that started -with the surgery. -Yes. -What do you feel in your body? -Tingling,

Accelerated heartbeat, shortness of breath. I have to lay down every time it happens. If I stand, I fall. Whoever makes the bariatric surgery feels it. It’s really bad, it’s a side-effect that will last after the surgery. 5 to 10% of Brazilians have a formal indication for bariatric surgery.

We’re talking about 15 million Brazilians. -Exactly. -10 to 15 million. Who will operate in all those people? Exactly, the waiting lines for bariatric surgery are huge. SUS offers free surgical treatment for obesity, but it doesn’t offer free clinical treatment for obesity. Which means, sometimes patients end up in surgery

Because they don’t have a good clinical treatment at SUS. This has to change immediately, otherwise we will fill the surgery lines and it will not give way for this to be done. Andreia, you’ve been in the waiting line for surgery -for three years. -Waiting for the surgery. Waiting. What about you,

When did you start to gain weight? I was always obese, but I started to gain weight very fast. Within two years, I gained 30 kilos. Then I started to feel bad, I was diagnosed with diabetes… All this waiting for the surgery stresses you out? A lot, doctor. Because sometimes I think:

“Is this surgery really coming on time?” Because my blood pressure is always high, I switched medicines three times, because it’s very hard to control it. I get really distressed with all this waiting. To understand one of the agents responsible for this, I decided to talk to Wilson Mello, representant of “ABIA”,

Brazilian Association of Food Industries. Lots of people accuse industries of making aggressive advertising, targeting kids, mainly, about candies, chocolates, high calorie foods. The advertising question really needs to be monitored and worked. The Brazilian food industry has voluntary agreements that prohibit them of making an advert targeting kids.

But, on the other hand, we see in advertising a way to communicate this change on the nutritional profile of food, to give better information to this customer, and give them possibilities to know about innovation, new products, new technologies and even products that can be considered healthier.

Don’t you think industries could do something more to educate children, or even the population in general, of topics on diet -and obesity problems? -I do. We’ve been working on it. We’ve been discussing with Federal Government about ways to contribute to this explanation and to give more information to population in general,

But also for kids. Luciana says you indulge in candies and says you’re wrong about doing it. -Does she indulge in soda? -Yes. I’m not the best person to say, because I also like candies. Do you even control -your blood sugar, Luciana? -I don’t. You don’t? Let’s check your blood sugar levels, then.

You’re a little overweight. You don’t exercise. You have everything to develop diabetes. 179. Do you know what the problem is? Your mom and dad suffer with diabetes, if you want to suffer with it too… -You’re in the right path. -I am. -Just keep doing it. -I’m doing it right. Right.

You can’t have diabetes and a sedentary life. You can’t be at prediabetes range -and live that life. -And live that sedentary life. Your risks of developing diabetes are very high. You watched our talk with Mrs. Teresinha and Luciana. They both are assisted by SUS and they are happy with it.

The problem is Mrs. Teresinha has diabetes and eats lots of candies. And Luciana, with high blood pressure, doesn’t take medicines. Where is the system’s flaw? It’s not on the assistance, but on the information. Both of them have no idea of the risks on having hypertension and diabetes.

And the problem of Andreia and Armando, with SUS, is different. They both are aware of the risks of obesity and are willing to do any sacrifice to get rid of it. Armando took so long to get the surgery, and Andreia has been on the waiting line for three years,

Without any perspective of being called for the bariatric surgery. SUS has a hard time organizing the assistance of complex diseases like this. Luciana, we checked your blood glucose. Let’s check your blood pressure. 167 over 104, which means 16/10. It’s very high. Medicine says that high blood pressure is a silent killer.

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