What is Obesity?
For the definition of obesity, the definition of the World Health Organization was taken as a basis. According to this definition, obesity is excessive and abnormal fat storage that can impair the health of the body. Excess fat stored in the body harms the optimal functioning of tissues and organs. It not only causes great damage to the circulatory and musculoskeletal system, but also to mental health. The fat stored around the waist has a great effect on cardiovascular diseases.
Obesity is an increasing disease in recent years. A large part of the world carries out various government policies to deal with this problem. In our country, obesity is rapidly reaching large masses due to the decrease in nutritional quality, the spread of packaged products and fast food culture and other reasons. Sedentary life, working from home, short distance driving and other social reasons cause obesity to increase rapidly. The increase in the number of obese people causes an increase in health expenditures. It affects both the health and economy of the people of the country in the first degree.
The number of obese people in Turkey has reached the level of 30% of the country’s population. In women, this rate reaches 50%. Especially in children and young people, bad eating habits trigger obesity at very young ages. People who are faced with obesity should first aim to reach to a healthy weight naturally. Regular diet and exercise are the two biggest helpers in this regard. If the person cannot be successful at the desired level in these matters and cannot resist obesity, obesity surgery comes into play. The most frequently preferred surgeries in obesity surgery are sleeve gastrectomy and gastric bypass surgeries. Considering the general health status of the person and the current health problems, which surgery should be preferred is determined. The method used in the measurement of obesity today is the calculation of the body mass index. With this calculation method, the weight group of the person is determined and action is taken accordingly.
How Is Obesity Treated?
The first preferred method in the treatment of obesity is diet and regular exercise. Habit changes, an active life and proper nutrition are sufficient in the treatment of obesity. However, surgical methods may also be used in cases where the person cannot cope with obesity and immediate actions are required. Among the surgical methods, the most preferred methods are sleeve gastrectomy and gastric bypass surgeries.
In the treatment of obesity, the following methods should be tried, respectively.
Nutrition Therapy: Dietary habits carried out during the day should be noted and rearranged in the light of the information obtained. In this regard, it is necessary to get professional help by a dietitian. Practicing the right nutritional therapy is certainly not about eating less. The important thing here is to create a calorie deficit and to lose weight in a healthy way by keeping the foods that the person needs in its diet.
Exercise Therapy: One of the biggest reasons for the rapid increase in obesity is bad eating habits and sedentary life. Exercise therapy is essential to get rid of excess stored fat. A good diet and exercise plan are two important pillars of the weight loss process.
Medication: Various diseases may have an important role in the occurrence of obesity. The most common ones in this regard are the diseases that affect thyroid functions and cause endocrine disorders. As a result of the examinations carried out by the specialist physician, medication can be started. In addition to medication, diet and exercise should also be followed.
Surgical Therapy: If the person reaches very high weights, surgical therapy may be activated. However, it should not be forgotten that those who have a weight above a certain level cannot undergo surgical treatment. In order for sleeve gastrectomy or gastric bypass surgery to be performed with minimum risk and without any problems, it is necessary to be below a certain body mass index. In this respect, it may be necessary to follow a special diet plan before surgical therapy.
Behavioral Therapy: The majority of people who undergo surgical treatment and fail experience this situation because they cannot change their eating and drinking behavior. In this regard, behavioral therapy is extremely important. Every surgically treated person should also receive behavioral therapy.
Causes of Obesity Disease
The main cause of obesity is to consume more calories than the calories burned. The person goes round in circles with the deterioration of its eating and drinking habits and its desire to eat more every day than the previous day. With each new day, the calorie deficit increases and the extra calories are stored as fat in the body. When a certain body mass index is reached, it is entered into the obese category. Among the indirect causes of obesity, there are also psychological, sociological, cultural, genetic and environmental factors.
In today’s social life, being obese is not a very distant possibility. While the person thinks that he/she is fed in moderation, he/she may suddenly find himself/herself in the obese category. Many people in our country are not even aware that they are in the obese category. Although it is tried to create public awareness on this issue, it is progressing to an inevitable end with the deterioration of nutritional habits with each passing day and the increase in low protein, high carbohydrate and fat diets.
The direct and indirect causes of obesity are listed as follows;
- Hormonal disorders,
- Genetic predisposition,
- Mental problems,
- Alcohol and antidepressant use,
- Medication (hormone drugs, drugs used in in vitro fertilization treatment),
- Heavy diets in the past,
- Consecutive pregnancy,
- High calorie and unhealthy eating habits,
- Sedentary life,
- Less and irregular sleep,
- Sociological effects
How to Measure the Degree of Obesity?
Obesity is classified together with the calculation of the body mass index. A standard formulation is used to calculate the body mass index. It is found together with the weight divided by the square of the height. When calculating, it is necessary to take the height in meters. For a person who is 100 kilos and 1.71 m tall, the body mass index is calculated as 100 ÷ (1.71 x 1.71) = 34.2 kg/m2.
In order for a person to be in the healthy category, they must be in the range of 20-25 kg/m2. People over 30 kg/m2 are classified as obese. Obesity also has its own sub-classifications. These are;
- 1st degree (BMI is between 30 – 35 kg/m²)
- 2nd degree (BMI is between 35 – 40 kg/m²)
- 3rd degree (BMI is between 40 – 50 kg/m²). Another name for the group with 3rd degree is the morbid group. It is also called deadly obesity.
- Super morbid obesity corresponds to the group with BMI over 50 kg/m².
What Health Problems Does Obesity Cause?
Obesity brings many health problems with it. Problems begin to appear in the endocrine system, cardiovascular system, respiratory system and musculoskeletal system directly. Along with other diseases caused by obesity, the person enters into a complex problem. The solution to these problems can only be achieved by losing weight and reaching a healthy weight. The health problems caused by obesity are listed as follows;
- Insulin resistance – Hyperinsulinemia
- Type 2 Diabetes
- Coronary artery disease
- Hyperlipidemia – Hypertriglyceridemia (Rise of Blood Fats)
- Metabolic syndrome
- Respiratory disorder
- Pregnancy complications
- Menstrual disorders
- Excessive hair growth
- Increased risks of surgery
- Mental problems
- Gallbladder diseases
- Various types of cancer (large intestine, prostate, gallbladder, endometrium, ovarian and breast cancer)
- Sleep apnea
- Fatty liver
- Social incompatibilities
- Skin infections, fungal infections in groin and feet
- Musculoskeletal system problems
Obesity Diagnosis and Treatment Methods
There are many different diagnostic and treatment methods used in obesity and metabolic surgery. The most preferred methods are listed below.
It is a surgical method in which the stomach is cut in a vertical direction and shrink by 80%. With the reduction of stomach volume, the person reaches fullness with much less eating and drinking activity. It aims to lose weight with a restrictive approach. In sleeve gastrectomy surgery, no operation is performed on the intestines. In this respect, it does not pose a problem for the absorption of nutrients in the long term. It is the most preferred obesity surgery option. It allows to perform revision surgery. It offers the possibility of losing weight, especially in the first 3 months.
RNY Gastric Bypass Surgery
The stomach is divided into two parts and it aims with the process made to the small intestine to reduce the areas where the nutrient absorption is performed in the intestines. With this approach, both the stomach shrinks and nutrient absorption decreases. It is a much more complex operation than sleeve gastrectomy surgery. Depending on the person’s history and diseases, it may be preferred instead of sleeve gastrectomy surgery. Gastric bypass surgery is recommended especially for patients with Type 2 diabetes and it is extremely successful. The negative side is that it requires lifelong supplemental vitamin and mineral support due to reduced nutrient absorption. There is no such requirement in sleeve gastrectomy surgery.
Mini Gastric Bypass
The biggest difference from RNY gastric surgery is that the intestine is joined without separating it. With fewer connections to be made, the surgery takes much less time. In this method, the presence of pancreatic and bile fluids close to the new gastro-intestinal junction increases the risk of bile reflux. The most preferred situation is to use it as a revision surgery if a person who has had sleeve gastrectomy surgery gains weight again.
Biliopancreatic Diversion and Duodenal Switch
It is the surgical treatment method that causes the most absorption disorders. The reason is that with the shrinkage of the stomach, the stomach is cut from the connection point to the small intestine and joined to the last part of the intestines. It can be applied as a single or double connection as in gastric bypass models. Its metabolic effects are very high. The person needs to take vitamin and mineral supplements throughout his life. It is generally preferred as revision surgery to people who failed after sleeve gastrectomy surgery.
Adjustable Gastric Band
It is known as a gastric band. The gastric band, which is made of silicone material, is placed just below the area where the stomach and esophagus meet. The band, which has an adjustable pressure, provides weight loss with a food restriction approach. Due to the many health problems it creates, it is not preferred much today. Among the problems, band slippage and abrasion of the stomach wall come first.
Frequently Asked Questions About Obesity
Is obesity a kind of disease?: Obesity is considered as a disease due to its characteristics and the great damage it causes. It also invites many diseases along with it.
Is obesity genetic?: Obesity is not dependent on a single factor. Although genetics also have an effect, a person enters the obese category with the combination of many different factors.
Does the habit of eating fast food cause obesity?: There are three basic pillars of obesity. Genetic factors, bad eating habits and living a life away from exercise. The habit of eating fast food is also an important factor in the category of bad eating habits. Consumption of too much fast food can cause obesity as it will create a regular calorie surplus.
Is a sedentary life effective on obesity?: As soon as a person who had a sedentary life leads to bad eating preferences, he or she starts to travel to obesity quickly.
What is the age range where obesity is most common?: Obesity was mostly seen in retired people in the past. However, it is seen that children and young people join this group very quickly. With the change in social life, children meet obesity much faster.
Does obesity cause other diseases?: The main reason why obesity is so dangerous is that it triggers many important diseases. It is directly related to all risky diseases.
Is it very difficult to get rid of obesity?: It is not difficult to get rid of obesity by following the created diet and exercise plan. However, it requires patience and determination. Making serious changes in the daily living habits of the person along with the eating and drinking habits accelerates the process.