Meet Dr. Manzanera, who leads the Obesity Clinic at Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, an Affiliate COM based in Mexico City. This COM has a multidisciplinary team of four endocrinologists, one psychiatrist, three surgeons, two surgical fellows, four obesity fellows, three nutritionists, seven social service nutritionists, two psychologists, and one physical educator fellow.
Welcome, Dr Manzanera. Please could you tell us about the specific obesity treatments and services your multidisciplinary COM offers?
We are a third-level reference hospital, and most of our patients have grade 2 and grade 3 obesity (88%) and comorbidities related to obesity. Therefore, it is necessary to provide multidisciplinary treatment to these patients, including consultations among specialists within our Institute.
Great. Please could you describe the education and training activities your COM provides to students and other healthcare professionals?
The Obesity Clinic facilitates training medical residents (ranging from 4 to 6 per year) specializing in endocrinology or internal medicine. These residents are enrolled in a High Specialty Course in Obesity sanctioned by the Ministry of Health and the National Autonomous University of Mexico (UNAM). Throughout their tenure, residents actively participate in clinical activities, conduct research projects, attend research seminars, engage in bibliographic sessions, and contribute to developing and discussing clinical cases. The comprehensive academic program encompasses critical subjects such as Guidelines for Obesity, Bariatric Surgery, Diabetes Mellitus, Hypertension, Dyslipidemia, and Eating Disorders. The curriculum includes in-depth coverage of comprehensive diagnosis for the management of obesity, incorporating the use of the Edmonton Obesity Staging Scale (EOSS); molecular and genetic bases of obesity; comorbidities of obesity, including diagnosis and treatment; medical, nutritional, and surgical treatment of obesity; reviews of neurobiology and psychopathologies; and strategies to support patient involvement in management. Furthermore, annually, the Obesity Clinic conducts an Obesity Course featuring national and international speakers. For details, please take a look at the latest program available here.
It sounds like there are a lot of exciting activities going on in your COM. Is your COM currently involved in any research projects?
Yes. Currently, the research projects under development at the clinic are wide-ranging. Ongoing projects aim to increase understanding on many topics, including weight and obesity treatment outcomes; surgery and medical interventions for obesity; COVID-19 and obesity; binge eating disorders and neuropsychology; long-term health effects after treatment; and sarcopenic obesity and malnutrition. For example, an ongoing project focuses on weight and comorbidities outcomes in the intensive maintenance phase after a multidisciplinary program to treat the obesity. There are multiple projects which focus on the effectiveness of bariatric surgery and related post-operative complications. For example, one project examines the association of anthropometric changes with metabolic parameters to indicate success in patients undergoing bariatric surgery over a real-life study at a five-year follow-up. Another evaluates psycho-social risk and its association with outcomes in weight and Edmonton Obesity Staging System (EOSS) in patients with bariatric surgery.
Does your COM engage with the wider community and/or health system around awareness, prevention and treatment of obesity?
One of our COM team members, Dr. Verónica Vázquez Velázquez, is engaged with a community of patients with overweight and obesity. Dr. Verónica Velázquez is the president of “Obesidades,” a non-profit organization and community made up of people living with obesity, healthcare professionals, and civil society.
Thank you, Dr. Emma Adriana Chávez Manzanera, for the insightful interview. This discussion provided an overview of the EASO COM Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán’s comprehensive approach to obesity management, its educational initiatives, ongoing research projects, and community engagement efforts.