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Llega a España Mounjaro, el medicamento que trata la obesidad y la diabetes: ¿me lo recetará mi médico si quiero perder peso? El paciente debe ser informado por el médico de lo que supone la ingesta de los medicamentos que tratan la diabetes y la obesidad. Getty.
El próximo 1 de julio llegará a las farmacias españolas un nuevo medicamento contra la diabetes y la obesidad , el primero con esa doble indicación. Se llama Mounjaro y será la competencia de Ozempic y de Wegovy , con una importante diferencia: mientras Ozempic está financiado por Sanidad como tratamiento para la diabetes, Mounjaro, como Wegovy, no estará financiado por el sistema público de salud , aunque sí necesitará prescripción médica.
Mi dieta cojea, sobre el Ozimpic
Diabetes y obesidad Obesidad y diabetes mantienen una relación muy estrecha. Hay distintos tipos de obesidad. El sobrepeso , con un índice de masa corporal (IMC) de 25 a 29,9, es el primer estadio y uno de los más frecuentes. Después está el segundo tipo, con un índice de masa corporal de entre 30 y 35. Antecede a la de mayor gravedad y peores efectos para la salud, cuando el IMC es superior a 40 .
En España la obesidad y la diabetes afectan a más del 30% de la población . Hay un 15% de personas con diabetes tipo 2 y un 18% con obesidad. Cuando bajamos de peso, el riesgo de diabetes y enfermedades cardiovasculares también baja. Y cuando se trata la diabetes, un efecto habitual es la pérdida de peso . Por esta razón, los medicamentos contra esta enfermedad viven un auténtico boom como reguladores de los kilos de más .
Hackeadores del Hambre: cómo saber si son para ti los medicamentos para la obesidad que triunfan en TikTok
Nuevo fármaco La farmacéutica Lilly acaba de presentar el inyectable Mounjaro , ya disponible en Estados Unidos, Alemania, Reino Unido y Polonia. En España costará 271 euros .
Su principio activo es la tirzepatida . La compañía, que insiste es que solo debe administrarse con prescripción médica y que en ningún caso debe utilizarse con fines cosméticos , asegura que el 90% de los diabéticos logra el control glucémico y que la pérdida de peso es significativa, de más de 23 kilos. Sin embargo, esta pérdida ocurre en una pequeña parte de los pacientes después de más de un año de medicación. Lo habitual es que se pierda entre un 5 y un 10% del peso .
La tirzepatida es un hipoglucemiante , un fármaco con la capacidad de reducir los niveles de azúcar en sangre parecido a los análogos de la GLP-1 que se incluyen en las fórmulas de Ozempic y Wegovy. Se trata de un medicamento nuevo; por tanto, aún se sabe poco de su comportamiento . Lo que se conoce hasta ahora proviene de los estudios preclínicos, de los ensayos clínicos y de la experiencia de uso acumulada desde su comercialización en 2022. Como en cualquier nuevo medicamento, los pacientes deben estar atentos a cualquier efecto adverso y comunicárselo a su médico o la Agencia Española de Medicamentos a través del portal NotificaRam.
¿Lo recetarán para controlar el peso? Mounjaro se publicita como un medicamento indicado para tratar tanto la diabetes y la obesidad. Como decíamos anteriormente, hay una relación entre ambas enfermedades. Si estamos ante un paciente diabético, el médico, con las pruebas necesarias que acrediten la patología, podrá recetar Mounjaro, aunque, al no estar financiado por Sanidad, el paciente tendrá que costearlo . En cambio, como tratamiento de la diabetes, Ozempic sí está financiado íntegramente por la Seguridad Social.
Si la pérdida de peso es puramente estética; es decir, se tiene un IMC entre 20 y 25, no sería razonable recetar este fármaco. En la balanza de riesgos y beneficios médicos, bajar de peso sin un problema de salud tomando un medicamento nuevo no exento de riesgos -algunos estudios clínicos vinculan la tirzepatida con ciertos cánceres de tiroides- no parece una buena idea.
Depende del caso Como precedente, la venta de Ozempic para perder peso se ha disparado en los últimos tiempos poniendo en aprietos el suministro para los diabéticos porque muchos facultativos lo recetan fuera de la indicación . En las consultas privadas, basta con la receta o recomendación médica para poder comprar cualquiera de estos fármacos, con diferentes precios dependiendo de las dosis. ¿Todos los médicos van a hacer esa recomendación? Depende de cada caso y cada facultativo.
¿Y en la sanidad pública? La situación es parecida. Los médicos consultados explican que el escenario es variopinto. También depende del caso, del celo del profesional a la hora de explicar las terapias y de su nivel de conocimiento . Un estudio realizado por el Hospital Universitario Arnau de Vilanova de Lleida y la Fundación de la Sociedad Española de Endocrinología y Nutrición revela que el 37% de los profesionales médicos reconoce no tener suficientes conocimientos para poder prescribir medicamentos para la pérdida de peso de forma segura. Este tipo de fármacos tienen que pautarse de por vida , siguen necesitando la colaboración del paciente respecto a cambio de hábitos y conllevan algún riesgo . Todo eso, en un escenario ideal, debe ser conocido por el paciente antes de insistir en la prescripción.
Respecto a casos concretos, y cuando no hay diabetes, tenemos que volver a recurrir al IMC . Si no hay sobrepeso y queremos adelgazar con fines estéticos, no parece probable obtener la receta . En otros casos, sí. Cuando un paciente tiene una obesidad mórbida , aunque no tenga diabetes, necesita adelgazar porque su salud está amenazada y su calidad de vida es mala.
Si otro paciente ha probado distintas fórmulas para bajar de peso y no lo consigue, también puede recetarse como tratamiento contra la obesidad. Cualquiera de estos fármacos ayudan a bajar peso en poco tiempo y serán una buena solución. Pero esos pacientes tienen que saber dos cosas: al no ser diabéticos, tendrán que costearlos de su bolsillo y serán recursos transitorios . Cuando estos fármacos no se acompañan con cambios en el estilo de vida, con una alimentación sana y más actividad física, los kilos volverán con efecto rebote y, con ellos, el riesgo de desarrollar las enfermedades asociadas a la obesidad .
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