Obesity, one of the biggest health issues of our time, is increasingly affecting Turkey each year. A large portion of the world’s population is implementing various government policies to combat this problem. In our country, obesity is rapidly reaching large populations due to factors such as declining nutritional quality, the spread of packaged and fast food eating habits, and other reasons. Sedentary lifestyles, working from home, short-distance driving, and other social factors are contributing to the swift rise in obesity rates.
The increase in the number of obese individuals leads to a rise in healthcare expenditures. It directly impacts both the health and economy of the country’s population. Creating individual awareness about obesity and acquiring detailed information are primary factors in preventing obesity. Those fighting obesity can update their lives with healthy routines and, if necessary, apply the correct obesity treatments, thereby overcoming obesity in a short period. The number of obese individuals in Turkey has reached 30% of the national population. Among women, this rate rises to 50%. Particularly in children and young people, unhealthy eating habits trigger obesity at very young ages. Individuals facing obesity should first aim to achieve healthy weights through natural methods.
Regular diet and exercise are the two biggest aids in this regard. When an individual is unable to achieve the desired level of success in these areas and cannot combat obesity, obesity surgery comes into play. The most frequently preferred surgeries in obesity surgery are sleeve gastrectomy and gastric bypass. The choice of which surgery to prefer is determined by considering the individual’s overall health status and existing health problems. The method currently used to measure obesity is the calculation of the Body Mass Index (BMI). Through this calculation method, the weight category of the individual is determined, and actions are taken accordingly.
The number of obese individuals in Turkey has reached 30% of the national population. Among women, this rate rises to 50%. Particularly in children and young people, unhealthy eating habits trigger obesity at very young ages. Individuals facing obesity should first aim to achieve healthy weights through natural methods. Regular diet and exercise are the two biggest aids in this regard. When an individual is unable to achieve the desired level of success in these areas and cannot combat obesity, obesity surgery comes into play. The most frequently preferred surgeries in obesity surgery are sleeve gastrectomy and gastric bypass. The choice of which surgery to prefer is determined by considering the individual’s overall health status and existing health problems. The method currently used to measure obesity is the calculation of the Body Mass Index (BMI). Through this calculation method, the weight category of the individual is determined, and actions are taken accordingly.
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Obesity, one of the biggest health issues of our time, is increasingly affecting Turkey each year. According to the World Health Organization’s (WHO) definition, obesity is the excessive and abnormal accumulation of fat in the body to a level that impairs health. Excess fat stored in the body damages the optimal functioning of tissues and organs. It not only adversely affects the circulatory and musculoskeletal systems but also significantly harms mental health. Fat stored around the waist has a significant impact on heart and vascular diseases. The current status of individuals is defined based on their Body Mass Index (BMI). According to the WHO, individuals with a BMI over 25 are classified as overweight, and those with a BMI over 30 fall into the obese category. Research indicates that due to obesity and the numerous accompanying diseases, more than 4 million people die each year. Obesity continues to rapidly increase not only among adults but also in children. Just 40-50 years ago, the percentage of childhood and adolescent obesity worldwide was 4%, but today it has risen to over 18%. Turkey is one of the countries where obesity is rising most rapidly. Unfortunately, while our country ranks at the top in Europe regarding obesity, it stands fourth in the world.
Obesity fundamentally refers to the extremely high levels of body fat and the numerous accompanying health issues it brings. Although it is often regarded as a health problem that is evaluated based solely on appearance, it is actually one of the most critical health issues that endangers human life. It includes heart problems, diabetes, high cholesterol, high blood pressure, liver damage and issues, sleep apnea, and various cancer risks. Moreover, obesity not only threatens individual health but also poses a threat to the economies of states. Health expenditures of obese communities begin to rise rapidly. The numerous diseases associated with obesity are the main factors contributing to this increase in costs. Therefore, when discussing the causes and harms of obesity, a much broader approach is necessary. Individuals facing obesity can have numerous different causes. The fundamental causes of obesity can be listed as follows:
Generally, when more than one of the above causes are combined, obesity arises. However, it is not possible to explain obesity with a single factor. Genetic factors alone do not make people obese. In this regard, there is absolutely no need to lose hope. Overcoming obesity is possible for every individual. Obesity has numerous harmful aspects, including the numerous health problems it brings, appearance issues, loss of self-confidence, social life problems, and more.
The most obvious symptom of obesity is the excessive accumulation of fat tissue in the body beyond normal levels. The symptoms of obesity are not only explained by appearance. The following signs are also among the symptoms of obesity:
The above signs can appear alongside obesity. Not everyone experiencing these issues is necessarily obese. However, an obese individual may face one or more of the above symptoms.
The treatment of obesity also varies depending on the type of obesity. Therefore, obesity types must be well understood and determined by a specialist doctor. Proper evaluations for the patient facing obesity help in determining the type of obesity. The most commonly encountered types of obesity can be listed as follows:
Among the listed types of obesity, the class in which the patient is found is determined, and the appropriate treatment method is selected. The most important step in overcoming obesity is accurate diagnosis and treatment process.
In brief, the question “What is obesity treatment?” can be explained as the successful completion of the process for patients who wish to achieve a healthy weight through the correct methods and habits, and subsequently maintaining protection against obesity. Patients facing obesity may sometimes fail to lose weight using their own methods. Genetic factors, wrong eating routines starting from a young age, and anatomical factors can make it difficult to overcome obesity. In such situations, receiving support from a specialist doctor is the healthiest option. Obesity treatment cannot be approached from a single perspective. For successful treatment, both the proper application of the method and the patient’s fulfillment of their responsibilities are necessary. In the surgical phase of this process, help should be sought from doctors, while in other phases, assistance from dietitians, psychologists, and sports instructors is required. Obesity treatment not only ensures the patient loses excess weight but also supports the cessation or control of high-risk diseases. The fundamental approach to determining the correct obesity treatment method requires careful consideration of the tests to be performed on the patient and the obtained data. Firstly, the individual’s obesity status is determined based on their Body Mass Index (BMI). The Body Mass Index, calculated by dividing weight by height squared, determines the category in which the individual falls. After determining the category and conducting other necessary tests, the correct roadmap is drawn. The methods used in obesity treatment are divided into surgical and non-surgical methods. Non-surgical methods include, primarily diet and exercise, habit changes, and various medication therapies. Surgical methods include gastric banding, sleeve gastrectomy, gastric balloon, gastric bypass, mini gastric bypass, duodenal switch, among others.
Obesity treatment may be suitable for individuals who meet the following Body Mass Index (BMI) criteria:
Changing eating habits in a healthy direction should form the first step in treatment. Nutrition experts should develop balanced and personalized nutrition plans tailored to the individual, taking into account the person’s age, gender, and habits. Restrictive and unsustainable diet programs should be avoided. It is important to remember that no method that is not sustainable can achieve permanent success. Nutrition education is also highly important in the post-obesity surgery period. To establish a healthy eating regimen from scratch after surgery, guidance from expert dietitians is essential. The most frequently encountered situation in weight regain after obesity surgery, especially sleeve gastrectomy, is patients who are left unsupported and isolated.
Exercise therapy should be applied in addition to nutritional therapy. The goal of exercise programs is not only for the individual to lose weight but also to preserve muscle mass and maintain the continuity of the weight loss process. Acquiring exercise habits is an indispensable part of long-term success after obesity surgery. Exercises should be gradually added in a sustainable, varying intensity, and injury-free manner, suitable to the individual’s current weight and condition. Individuals who engage in regular exercise have a significantly higher rate of maintaining their achieved weight compared to those who do not exercise.
Behavior change therapies play a crucial role in modifying individuals’ eating habits, especially during the post-obesity surgery period. Emotional states that drive individuals to overeating and strategies to cope with them should be evaluated by a specialist. Training should be provided to teach individuals how to find pathways to overcome such situations. In behavior therapies, if necessary, medical drug treatments can also be planned by consulting a specialist psychiatrist. Those who fail after sleeve gastrectomy are typically individuals who have abandoned their treatment programs and remain unsupported.
In the pharmacological treatment of obesity, it is essential to first investigate diseases that could cause obesity. Particularly, diseases affecting thyroid functions and endocrine disorders should be examined by a specialist doctor, and medical treatment should be initiated when necessary. Especially in metabolic syndrome caused by obesity, weight loss becomes quite difficult. In obesity treatment, a multidisciplinary approach including nutritionists, behavior therapists, and specialist doctors maximizes the chances of success.
As the amount of weight to be lost increases, more serious steps may need to be taken in the treatment stages. Today, the most effective treatment for obesity is surgical procedures. In addition to surgical treatments, endoscopic methods such as gastric balloon and gastric injection are also used in obesity treatment. Treatment success rates are considerably lower compared to surgical treatments. Obesity surgeries such as sleeve gastrectomy, gastric bypass, mini gastric bypass, duodenal switch, bipartition, and sadi-s are surgical treatment methods with more permanent and high success rates. Among these types of surgeries, sleeve gastrectomy is the most frequently performed surgical treatment option worldwide today.
In recent years, gene therapy has become a field focusing on the genetic foundations of obesity. Understanding the genetic factors that lead to obesity allows for the development of personalized treatment methods. The latest research in this area and future potential applications related to gene therapy are continuously being examined.
The effects of gut microbiota on obesity have become a significant topic in current research. This section explores the role of probiotics and prebiotics in obesity treatment, the relationship between microbiota diversity and weight control, and how these factors interact to influence obesity management.
The impact of neurotransmitters in the brain, particularly on feelings of hunger and satiety, constitutes another important area studied in obesity treatment. This section details the effects of new drug developments and neurotransmitter-regulating treatments on obesity management, highlighting how these advancements contribute to more effective obesity therapies.
Each individual’s genetic makeup, lifestyle, and metabolism are different. Personalized treatment approaches are a significant advancement in obesity treatment. This section evaluates personalized treatment methods such as genetic testing, metabolic profiling, and customized diet programs, emphasizing their role in creating effective and individualized obesity management plans.
Mobile applications, wearable technologies, and digital health platforms play an important role in patient monitoring, motivation, and awareness in obesity treatment. This section examines the integration of these technologies into obesity treatment processes and the advantages they provide. These new approaches and ongoing research in obesity treatment enable the development of more effective and personalized solutions in the fight against obesity.
Childhood obesity is generally a problem that can continue into later ages. This section should cover the causes of childhood obesity, healthy weight loss strategies for children, the importance of family involvement, and the latest developments in childhood obesity treatment.
The adolescent period is a stage where significant changes occur in the body and hormonal balances are established. Obesity treatment during this period should be planned in accordance with the physiological and psychosocial needs of young individuals. Weight control, healthy eating habits, and exercise recommendations during adolescence should be thoroughly evaluated in this section.
The adult period is a stage where obesity generally becomes more prominent. This section should cover weight loss strategies, nutrition plans, exercise programs, metabolic changes with age, and hormonal effects in adult individuals.
In the elderly period, the effects of obesity can differ from those in younger individuals. This section should thoroughly examine the importance of weight control in the elderly, age-specific exercise recommendations, nutritional needs, and the specific aspects of obesity treatment in elderly individuals.
Metabolism, hormones, and weight control can have different effects between women and men. This section should cover gender-specific obesity treatment strategies, the effects of hormonal changes on obesity, and gender-specific weight management recommendations. Adopting personalized approaches in obesity treatment for individuals in all age and gender groups is a critical factor to increase treatment success.
Medication therapy in obesity treatment primarily involves investigating diseases that could cause obesity. Especially, diseases affecting thyroid functions and endocrine disorders should be examined by a specialist doctor, and medical treatment should be initiated when necessary. In metabolic syndrome caused by obesity, weight loss becomes particularly difficult. A multidisciplinary approach in obesity treatment, including nutritionists, behavior therapists, and specialist doctors, maximizes the chances of success.
Orlistat supports weight loss by reducing the amount of fat absorbed by the body. It inhibits an enzyme called lipase in the intestines, which prevents the absorption of a portion of the fat passing through the intestines. Side Effects: Greasy stools, gas and abdominal pain, diarrhea, risk of fat-soluble vitamin deficiency.
Phentermine promotes weight loss by suppressing appetite. Topiramate affects appetite control and increases the feeling of fullness. Side Effects: Insomnia, dry mouth, headache, loss of appetite, memory problems (side effect of topiramate).
Liraglutide helps control appetite by increasing the activity of an insulin-like hormone and extending the stomach emptying time. Side Effects: Nausea, vomiting, pain at the injection site, diarrhea, risk of pancreatitis.
Sibutramine controls appetite by affecting serotonin, norepinephrine, and dopamine levels. Side Effects: High blood pressure, rapid heart rate, insomnia, dry mouth.
Naltrexone and bupropion affect appetite control and increase energy expenditure. Side Effects: Headache, insomnia, nausea, constipation or diarrhea. These medications are usually used in conjunction with diet and exercise for weight loss. However, it is important to use them under doctor’s supervision, and in case of any concerns about side effects, immediately contact a healthcare professional.
Obesity treatment may not only include surgical interventions. In some cases, non-surgical or non-invasive methods can also aid in weight control.
To identify and eliminate psychological and behavioral factors that play a significant role in the causes of obesity, expert support in these two areas should be obtained.
Diet and nutrition programs play a fundamental role in obesity treatment. Special diet plans prepared by nutrition experts promote healthy weight loss by balancing the individual’s energy intake. Diets based on high-fiber, low-fat, and balanced nutrition principles can be effective in obesity treatment.
Obesity treatment yields very good results when combined with exercise methods. If the individual does not have metabolic and genetic issues, it is possible to lose weight with routine exercise programs. A large portion of patients facing obesity are individuals who work at desks and have very little social mobility. In this regard, a proper exercise plan will ensure that the individual achieves a healthy weight.
Some medications used under doctor’s supervision can aid in weight control. These medications are special formulations that control appetite or promote weight loss by affecting metabolism. However, it is important to consult a healthcare professional before deciding whether medication therapies are effective and safe. Medication therapy used for metabolic and hormonal issues can be an important factor in overcoming obesity.
The gastric balloon method is the most preferred and aims to reduce stomach volume among non-surgical methods. Along with the gastric balloon used, a significant volume of the stomach is filled with the gastric balloon. This ensures satiety with much smaller portions. With reduced calorie intake, a rapid weight loss process can be achieved. These non-surgical methods can be applied depending on the individual’s health status, weight loss goals, and other individual factors. However, it is essential to consult a healthcare professional before starting any treatment.
The most frequently used applications in obesity surgery can be listed as follows:
In sleeve gastrectomy, the aim is to reduce the size and hence the volume of the stomach. In this operation, up to 80% of the stomach is removed. By reducing the stomach volume, the patient will reach the feeling of fullness much more quickly during meals. The formation of a feeling of fullness with small portions will accelerate the weight loss process. While a large portion of the stomach is removed, the part where appetite hormones are secreted is also removed. Therefore, significant appetite loss will occur in the patient after the operation. Along with sleeve gastrectomy, while overcoming the obesity problem, issues like diabetes and hypertension can also be resolved. Within a 12-month post-operation period, it is possible to lose up to 80% of the excess weight. During this period, the person must also adhere to the diet and exercise program. Otherwise, there is a likelihood of facing obesity again.
In gastric bypass surgery, in addition to the stomach reduction procedure, a procedure aimed at reducing food absorption is applied. Along with gastric bypass surgery, a large portion of the stomach is removed, and the remaining small portion is directly connected to the small intestine. Because a significant portion of the intestine will be bypassed, a portion of the nutrients will be excreted from the body without absorption. This means reduced calorie intake. Diabetic patients using insulin can control their blood sugar problems thanks to gastric bypass surgery. There will be an 18-month weight loss period after the surgery. Reduced absorption will also cause deficiency in the vitamins obtained from food. Therefore, individuals who have undergone gastric bypass surgery will need to take vitamin supplements for a long time. After the surgery, a professional nutrition program is established to ensure the process is monitored healthily.
It is the much simpler version of gastric bypass surgery. The surgery is completed in a much shorter time. With this method, Type 2 diabetic patients will also achieve significant improvement.
It is a method preferred for individuals with a Body Mass Index over 50. In the duodenal switch method, additional procedures are applied to reduce food absorption. It is possible to eliminate obesity-related high cholesterol, hypertension, and diabetes. However, it should be noted that the duodenal switch method is not frequently preferred due to the risk of various complications after surgery. After this operation, significant deficiencies in protein and vitamin intake can occur. Therefore, the patient will need to take additional food and vitamin supplements for an extended period.
Adjustable gastric band reduces stomach volume by placing a band around the upper part of the stomach. The band is used to adjust its tightness to control food intake and promote weight loss. This method is reversible compared to other stomach reduction surgeries.
Obesity surgery includes surgical interventions aimed at weight loss and typically used in individuals who are severely overweight or obese. The goal of obesity surgery is to support the patient’s weight loss process, eliminate obesity, and ensure the permanent removal of obesity from the individual’s life. The surgical procedures performed in line with the targeted goals are realized through the patient’s determination to achieve the objective.
When selecting an obesity surgery procedure, the patient needs to be examined from multiple aspects. For some patients, a stomach reduction operation may be sufficient; for others, an additional procedure to reduce food absorption may be necessary. The most frequently used procedures in obesity surgery can be listed as follows:
The aim of sleeve gastrectomy is to reduce the size and thus the volume of the stomach. In this operation, up to 80% of the stomach is removed. With the reduction of stomach volume, the patient will reach a feeling of fullness much more quickly during meals. The formation of satiety with small portions will accelerate the weight loss process. While a large portion of the stomach is removed, the part where appetite hormones are secreted is also removed. Therefore, significant appetite loss will occur in the patient after the operation. Along with sleeve gastrectomy, while overcoming the obesity problem, issues like diabetes and hypertension can also be resolved. Within a 12-month post-operation period, it is possible to lose up to 80% of the excess weight. During this period, the person must also adhere to the diet and exercise program. Otherwise, there is a likelihood of facing obesity again.
In gastric bypass surgery, in addition to the stomach reduction procedure, a procedure aimed at reducing food absorption is applied. Along with gastric bypass surgery, a large portion of the stomach is removed, and the remaining small portion is directly connected to the small intestine. Since a significant portion of the intestine will be bypassed, a portion of the nutrients will be excreted from the body without absorption. This means reduced calorie intake. Diabetic patients using insulin can control their blood sugar problems thanks to gastric bypass surgery. There will be an 18-month weight loss period after the surgery. Reduced absorption will also cause a deficiency in the vitamins obtained from food. Therefore, individuals who have undergone gastric bypass surgery will need to take vitamin supplements for an extended period. After the surgery, a professional nutrition program is established to ensure the process is monitored healthily.
This is the much simpler version of gastric bypass surgery. The surgery is completed in a much shorter time. With this method, Type 2 diabetic patients will also achieve significant improvement.
This is a method preferred for individuals with a Body Mass Index (BMI) over 50. In the duodenal switch method, additional procedures are applied to reduce food absorption. It is possible to eliminate obesity-related high cholesterol, hypertension, and diabetes. However, it should be noted that the duodenal switch method is not frequently preferred due to the risk of various complications after surgery. After this operation, significant deficiencies in protein and vitamin intake can occur. Therefore, the patient will need to take additional food and vitamin supplements for an extended period.
The adjustable gastric band reduces stomach volume by placing a band around the upper part of the stomach. The band is used to adjust its tightness to control food intake and promote weight loss. This method is reversible compared to other stomach reduction surgeries.
Although obesity surgery generally provides effective weight loss, it can bring some risks and potential complications. These risks include infection, bleeding, vitamin deficiencies, intestinal blockage, and other surgical complications.
The expected results after obesity surgery depend on the person’s weight status, surgical method, and other individual factors. Generally, obesity surgery accelerates the patient’s weight loss and can correct obesity-related health issues. However, success varies based on the individual’s post-surgery lifestyle and diet. Individuals considering obesity surgery should discuss this decision in detail with their doctors. Each method’s advantages, risks, and personal suitability should be evaluated.
Nutritional and lifestyle changes after obesity treatment are fundamental to the success of the process. At the beginning of the treatment, what the doctor will do and what the patient needs to do are clearly explained.
Changing eating habits after obesity surgery is critically important. Since stomach volume decreases after surgical intervention, individuals are expected to have more frequent and smaller portions in their meals.
Obesity surgery should be supported with regular exercise to accelerate weight loss and improve body composition.
Fluid intake is also an important factor after obesity surgery.
Individuals who undergo obesity surgery should have regular follow-ups with doctors and dietitians post-surgery.
Obesity surgery affects not only physical health but also psychological well-being. Therefore, obtaining psychological support after surgery is important.
Obesity treatment is not limited to just diet and medications. Physical activity and regular exercise play a significant role in the treatment process. After surgical obesity treatment, an exercise plan should be developed gradually. It should start at a very low intensity and increase in intensity over time. The exercise plan should be created by professional fitness trainers. Additionally, making the patient’s social life more active will enhance the speed and healthiness of the weight loss process.
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