Obesity

What is Obesity?

The World Health Organization briefly defines obesity as “an accumulation of fat in the body to the extent that it impairs a person’s health.” For women, 20% of body weight being fat, and for men, 25%, is sufficient for obesity. And this disease is a factor in the development of many additional diseases. According to the World Health Organization, the number of obese people has doubled in the last century, the problem of obesity is seen even in children under 5 years old, and it is rapidly progressing in both developed and developing countries. Considering its prevalence and the deadly diseases it causes, obesity is perhaps the most important disease of our time.

Causes of Obesity

Many causes of obesity can be listed. However, the two most important causes are a high-calorie diet and a sedentary lifestyle. If a person doesn’t pay attention to their diet and doesn’t engage in physical activity, obesity is almost inevitable. Unfortunately, metropolitan life, often described as a “modern lifestyle,” contributes to this problem. Besides excessive, high-calorie diets and insufficient physical activity, physiological, genetic, environmental, and psychological factors can also be considered among the causes of obesity.

• Excessive and high-calorie diet
• Sedentary lifestyle (lack of exercise, sports, physical activity)
• Psychological factors
• Genetic factors
• Certain medications
• Frequent and low-energy diets
• Age
• Gender
• Education level
• Social and cultural factors

How is Obesity Calculated?

Obesity is measured worldwide using a method called BMI (body mass index). In this method, a person’s weight is divided by the square of their height in meters.

Click here to easily calculate your Body Mass Index.

Obesity Treatment

The first and most important step in treating obesity is prevention. This prevention process should begin in childhood and is formed by healthy eating habits and daily activities. A person with obesity should not avoid seeking professional support. Treatment can be provided by a team consisting of a physician, dietitian, psychologist, and physiotherapist. The aim here is to reach the ideal weight ratio and acquire balanced eating habits, starting with the easiest methods.

There are several methods in the treatment of obesity. These are;

Dietary Treatment:The main goal here is to reduce the amount of calories consumed. Different methods can be applied to each patient. Because people’s metabolic rate, age, gender, lifestyle, and eating habits may be different. Therefore, it is more appropriate to carry out this treatment with the guidance of a dietitian and a physician.

Exercise Therapy: Exercising is essential for both overcoming obesity and living a healthy life. Everyone should incorporate exercise into their lives and make sports a part of their daily routine. Exercise therapy will be more beneficial when combined with diet. Diet and exercise should be tailored to the individual and carried out with professional help.

Behavioral Changes: The steps of behavioral change therapy are as follows:

• Self-observation
• Stimulus control
• Developing alternative behaviors
• Reinforcement, self-reward
• Cognitive restructuring
• Social support
• Pharmacological treatment

Drug Treatment: When the methods tried so far are ineffective, or in individuals with a BMI above 30 (including those with a BMI above 27 who have weight-related sleep apnea, diabetes, hypertension, etc.), drug treatment is applied. Although medications have no harmful effects, long-term use can cause some side effects. Therefore, they should be used under the supervision of a physician.

Obesity Surgery

Obesity surgery is a procedure applied to individuals with a BMI above 40 or above 35 who have additional diseases, in order to lose weight, improve additional diseases, normalize bodily functions, prevent weight regain, and improve quality of life. Individuals who are obese according to their degree, have tried other weight loss methods without success, and have no condition that would prevent them from having surgery can apply for obesity surgery. It is performed laparoscopically. Because it is a closed method, the patient’s recovery and response to treatment is very short; the complication rate is low. There are many obesity surgery methods, and the common goal of all of them is to reduce the absorption of energy and nutrients taken in through food in the digestive system. Gastric Bypass

Gastric bypass is performed to reduce the volume of the stomach and restrict absorption. It is frequently preferred in morbidly obese patients. It is one of the most commonly performed methods. It is performed using a closed method. In the first stage of the surgery, a small stomach tube with a volume of 30 ml is created at the entrance of the stomach, and the remaining large stomach is completely separated. In the second stage, a connection is made between the small stomach tube and the small intestine. Through this connection, food bypasses the large stomach and passes into the small intestine. In this way, the amount of food consumed is restricted. The feeling of hunger decreases, and less food is eaten. Blood sugar remains stable. A loss of 60 to 80 percent of excess weight is observed.

Sleeve Gastrectomy

Sleeve gastrectomy is the most frequently performed and, in our practice, the most common obesity surgery method. It can be defined as the removal of the fundus section, which constitutes 80% of the stomach. This reduces the hunger hormone and makes the person feel full. Significant weight loss is achieved. Sleeve gastrectomy is preferred because of the low number of postoperative complications and the possibility of converting it to malabsorptive surgery if necessary. It is performed laparoscopically (closed). During the surgery, a tube is placed in the stomach, and the greater crura section of the stomach is removed under the light of this tube and exited through a small incision.

Biliopancreatic Diversion (BPD)

Biliopancreatic diversion (Scopinaro procedure) surgery is a restrictive and inflammatory-reducing method used in the treatment of clinical, malignant, and morbid obesity. Approximately two-thirds of the lower half of the stomach is removed, leaving a stomach volume of 150-250 ml. This is performed laparoscopically. It reduces nutrient absorption. Due to its malabsorptive or malabsorptive properties, long-term medical follow-up and vitamin supplementation are required. Biliopancreatic diversion is highly advantageous in super morbid obesity, being beneficial in both weight loss and improving the course of diseases that develop with weight.

Duodenal Switch

Duodenal Switch is the most comprehensive weight loss method. It is the most effective method in conditions such as diabetes, high blood pressure, and high cholesterol. Unlike biliopancreatic diversion, a sleeve gastrectomy is performed in this surgery. In duodenal switch, the part of the stomach that produces the hunger hormone is removed, and the goal is to reduce the feeling of hunger and lose weight. However, it requires lifelong special diet and vitamin-mineral supplementation.

SADI-S

SADI-S can be described as an integrated form of biliopancreatic diversion surgery or duodenal switch surgery. It is generally applied to individuals with metabolic diseases such as hypertension, diabetes, and high cholesterol, and those who have not achieved the desired weight loss after sleeve gastrectomy surgery. After the procedure, patients may need to take vitamin and mineral supplements for life.