Obesity

The Disease of Our Age: Obesity

What is Obesity and How is it Treated?

Today, obesity is an important health problem not only in developed countries but also in developing countries. The role of increasing income levels, Western-style lifestyle, eating habits similar to fast-food and high-calorie and fatty nutrition in the increase of the obesity problem cannot be denied. Gaining excessive weight and not burning too many calories through nutrition is the main reason that triggers obesity. Today's people avoid physical activity, stay inactive for hours in front of their phones, computers and televisions, and in the meantime, constantly eat high-calorie snacks. With the increase in transportation vehicles, people walk less, and work less with the intensive entry of technological devices into our lives. On the other hand, our lack of sports habit as a society is also a factor in this.

What is Obesity and Morbid Obesity?

Obesity can be briefly defined as excessive fat accumulation in the body. The World Health Organization (WHO) defines obesity as "abnormal, excessive fat accumulation in the body in a form and proportion that will cause diseases."

Morbid obesity can also be defined as advanced obesity that poses a serious threat to life due to the fatal problems it poses. Those with a Body Mass Index (BMI) over 40 are considered morbidly obese.

The average body fat percentage is 25-30 percent in women and 20 percent in men.

Dangers of Obesity and Diseases It Causes

Obesity is Not a Cosmetic Problem

Obesity causes disorders in the entire body system. Experts state that obese people live 12-15 years less than their peers. Obesity, type 2 diabetes (diabetes mellitus), hypertension, cardiovascular diseases, fat metabolism disorders, sleep apnea

reflux, sexual disorders, joint and bone problems, respiratory system disorders. Since the external appearance of obese people is distorted, their social lives and mental health are also disrupted, and they face many problems such as depression. In addition, some types of cancer such as breast and colon cancer are more common in obese people.

How Should Obesity Be Treated?

Options for treating obesity:

1- Diet 2- Exercise 3- Drug therapy 4- Surgical treatment.

Exercise and diet play a major role in treatment, patients should first change their lifestyle. Patients should receive good nutrition education and learn the mistakes in this area. At this point, exercise should definitely be included in life. However, the side effects of most of these have been determined, and today there is still no very effective drug with few side effects. Studies show that the rate of permanent weight loss with non-surgical methods in the treatment of morbid obesity is around 2 percent. This shows that the permanent and effective treatment of morbid obesity is surgery.

Obesity treatment is a team effort. A team of endocrinology, general surgery, psychiatry, nutrition and diet specialists should evaluate the patient and determine the treatment method.

Which Patients Are Recommended Surgical Treatment?

Even if there is no additional comorbid disease in morbidly obese patients with BMI=40 kg/m2 and above, surgical treatment is indicated in obese patients with BMI=35 kg/m2 if they have at least one of the following diseases: hypertension, cardiovascular diseases, type 2 DM hyperlipidemia, sleep apnea syndrome.

What Methods Are Applied in Surgical Treatment?

Sleeve gastrectomy (Stomach Tube): The stomach is cut lengthwise with special staples and narrowed by turning it into a tube, it is a physiological surgery, it can be converted to another method in the future. That's why the most popular surgery in recent years is the sleeve gastrectomy. Sleeve gastrectomy both shortens the eating and reduces appetite.

Adjustable gastric band: Also known as a gastric band among the public, it is no longer used much due to its high complications and loss of effectiveness when excessive liquid calorie food is consumed. The problems caused by this surgery in the past have a major role in the public's distancing from obesity surgery.

Gastric plication: This is a type of surgery that has been on the agenda in recent years. The stomach is narrowed with stitches from top to bottom, complications are few but its effect is limited since the feeling of hunger continues.

Gastric Balloon: It is not a surgery. A balloon is placed in the stomach with endoscopy and inflated, creating a constant feeling of fullness in the stomach; it is not a weight loss method on its own. However, it is used in super morbidly obese patients, i.e. those who are overweight, to make the surgery easier by losing some weight or to support other treatments. It needs to be removed in an average of 6 months. It has side effects such as perforation, damage to the stomach, and causing intestinal obstruction.