Obesity is essentially defined as excessive fat accumulation in body. Affecting the entire world like a pandemic, obesity causes accumulation of fat in arteries and around the visceral organs, particularly the liver, which first leads to atherosclerosis (plaques develop inside the artery and this leads to insufficient blood supply to the tissues and organs) followed by numerous health problems including heart disease, heart attack, asthma, diabetes mellitus, hypertension and sleep apnea (temporary breathing lapse lasting for a few seconds during sleep).
How is Obesity Diagnosed?
Body Mass Index (BMI) is a globally accepted modality to evaluate the body weight. It is calculated by dividing the body weight (in kilograms) by the height (in meters) squared. Values above 25 in women and 30 in men imply obesity and values over 40 point to morbid obesity.
What Is the Function of Obesity Center?
At obesity center, a multidisciplinary team of internists, endocrinologists, obesity surgeons, dieticians, physiatrists and psychiatrists works. Considering the fact that the risk of co-existing diseases is very high in obese patients, the multidisciplinary team cooperates with all other medical departments.
Treatment of Obesity
Basically, obesity means that the energy taken with the foods consumed is more than the amount of energy necessary for the body to fulfill its functions. If the individual has no genetic predisposition or disease, the two major underlying factors of the obesity are unhealthy diet and sedentary lifestyle.
You have no barrier against your ideal body weight
Therefore, it is critical to follow this list in treatment of obesity:
- Diet Therapy
Since the main underlying cause of obesity is impaired energy balance, a special diet for the patient should be planned in the first step. Excess bodyweight should be gradually decreased to the ideal bodyweight with a plan made by the physician and dietician. As losing excess weight in a short time is an unhealthy approach, patients should strictly comply with the plan made by the physician and dietician. Healthy diet should not be solely considered as the treatment of obesity, it should be considered as the key to a healthy life.
- Exercise Therapy
Another way to prevent positive energy balance that leads to fat accumulation is to increase the calories burnt by the body. Although a physically active life and regular exercise are ways to get rid of obesity, this approach should be adopted by everyone who wants to maintain a long and healthy life.
Type, frequency, intensity and duration of exercise should necessarily be determined by a physician, a physiatrist and even an exercise coach, if necessary. Otherwise, the negative effects on heart and respiratory system will mask out the expected gain.
- Medication Treatment
The aim of medical treatment of obesity is to eliminate the underlying cause of obesity and treat the complications.
Medical treatment should necessarily be used as instructed by the physician and diet and exercise therapies should be simultaneously maintained for a successful treatment.
- Surgical Treatment
Although obesity surgery has historically aimed to enable weight loss, it has been discovered that in addition to the weight loss, it also eliminates the metabolic problems caused by obesity (hypertension, diabetes mellitus, hepatosteatosis, insulin resistance etc.) in time.
There are some criteria that the patients should meet to be eligible for obesity surgery. Those criteria include body mass index over 40 (this value is 35 for individuals with the diseases caused by obesity), inability to eliminate obesity with diet, exercise and medical treatment for at least one year, ability of the patient to understand the reason of obesity surgery and determining that the patient will comply with recommendations to maintain the ideal bodyweight after the surgery, absence of a hormonal disorder leading to obesity, patient’s being older than 15 years of age and absence of a disease that can contraindicate the surgery.
Although many techniques have been developed over years, below mentioned methods are employed for surgical management of obesity in modern medicine:
1. Gastric bypass: Gastric bypass surgery is included in group of combined surgeries since it both reduces the volume of stomach and decreases the absorption. First, the volume of stomach is decreased to approximately 30-50 cc in this surgery. Next, this small stomach pouch is connected to the last segment of the small intestines. Thus, patients can feel full with much less foods as the stomach is reduced. Absorption of digested foods decreases since the digested foods are bypassed a large part of the small intestine and reach the last segment of the small intestine. Gastric bypass surgery is the primarily preferred type of surgery for the patients who are diabetic, use insulin for a long time and have body mass index on borderline morbid obesity limits; the procedure is performed under general anesthesia successfully with laparoscopic (closed) method.
The results of gastric bypass surgery are irreversible. The surgery ensures permanent and effective weight loss. As is the case for all surgeries, gastric bypass surgeries can lead to certain complications. This is an approximately 15% risk while risk of serious complications is even lower.
2. Sleeve gastrectomy: Currently being the most commonly used surgical technique for reducing size of the stomach, this surgery has proven efficiency in weight loss and elimination of metabolic disorders. Similar to gastric bypass, sleeve gastrectomy is performed under general anesthesia; the stomach is given a tube or banana-like shape and its volume is decreased by 80%. Therefore, patients can feel full with a very low amount of food. Since the region of stomach secreting the hunger hormone (Ghrelin) is also removed, the appetite is suppressed.
Both reach your ideal body weight and get rid of medications you take for co-existing diseases
Patients lose weight and weight gain is also prevented with sleeve gastrectomy. Moreover, majority of comorbidities can also be eliminated and most of the patients do not need to use the medications they took for the co-existing fiseases.
Although successful outcomes are achieved with obesity surgery, the patients should be followed up for a certain time after these surgeries, they should use the vitamin supplements recommended by physicians and strictly follow the diet and exercise advices that are indispensable for a healthy life.
You can contact the global hospital and physician network of Hera Healthcare and receive counseling services for determining the most suitable surgery for your condition, setting health targets, maintaining the ideal body weight reached after obesity treatment and surgery.