What is Obesity?
Obesity is among the most important health problems of developed and developing countries today. Obesity is the increase in body weight above the desired level as a result of the excessive increase in the ratio of body fat to lean mass.Obesity is a disease that decreases the quality of life as the average life span increases, decreases the production capacity of people and must be treated.
As is known, nutrition; It is an indispensable need of life that begins in the womb and continues until the end of life
It is the ability to use in the body the nutrients necessary for human growth, development, healthy and productive life for a long time.
Feeding the stomach is not suppressing hunger, eating or drinking whatever you desire.
In daily life, the age, gender, work, genetic and physiological characteristics of individuals (pregnant, lactating, infant, school child, young, old, worker, athlete, cardiovascular, diabetes, hypertension, respiratory disorders, etc.) It needs daily energy that varies according to the situation.
In order to maintain a healthy life, it is necessary to balance the energy taken with the energy expended.
Adipose tissue constitutes 15-18% of body weight in adult males and 20-25% in females. The fact that this rate exceeds 25% in men and 30% in women constitutes obesity.
If the energy taken daily is more than the energy spent, the energy that cannot be spent is stored as fat in the body and causes obesity.
Parallel to this, the developments in today's technology, while making life easier, have significantly limited daily activities.
As can be understood, obesity; It is accepted as a disease that negatively affects the quality and duration of life, which occurs as a result of the energy (calories) taken with food more than the energy consumed and the excess energy stored as fat (20% or more) in the body.
By the World Health Organization (WHO), obesity has been defined as excessive fat accumulation in the body to the extent that it impairs health.
Across Turkey and abroad that treat obesity more than 3500 patients from Mediline Hospital General Surgery Specialist Exp. Dr. Fatih EROL states that they recommend surgery to obesity patients who cannot lose weight with their own efforts.
Noting that the World Health Organization and the Ministry of Health evaluated obesity as an epidemic, Uzm. Dr. Fatih EROL, "Obesity, 40 percent in our country, women, are found in 21 percent of men. Turkey average basis we receive 30 percent of the obesity situation said, noting body mass index were planning surgery for patients who are over 40, obesity patients in the treatment of their own skills Patients who cannot lose weight with diet, sports, exercise and medical treatment prefer obesity surgeries as a last resort. Thanks to the ever-developing obesity surgery, obesity surgeries are now performed in a very short time and within technical possibilities. We get good results. Many of our patients accept the day they are operated on as their birthday. Their quality of life increases a lot. Although their long distance walks, clothing, adaptation processes to social life are very good, their self-confidence increases. drink They get involved in business more easily
In our hospital, in the field of Bariatric Surgery, surgeries such as tube stomach, gastritis by-pass and bipartition for diabetics are performed with closed method using the latest technologies.
Stating that many patients come from Turkey and abroad, Uzm. Dr. Fatih EROL; "In Turkey, Istanbul, Ankara, Izmir and our patients from many cities, especially Istanbul comes Elazig. Still further abroad in Germany, patients in many European countries such as Austria prefers us. We're releasing our patients with successful operation"
What are the factors that cause obesity?
Although the factors causing obesity are not fully explained, excessive and malnutrition and lack of physical activity are accepted as the most important causes of obesity. In addition to these factors, many factors related to genetic, environmental, neurological, physiological, biochemical, socio-cultural and psychological cause obesity. It is accepted that the role of environmental factors in the formation of obesity is at the forefront, especially because the increase in childhood obesity is too high to be explained by changes in genetic structure.
The main risk factors for obesity are listed below:
Excessive and wrong eating habits
Insufficient physical activity
level of education
Socio - cultural factors
Hormonal and metabolic factors
Using very low energy diets frequently
Smoking and alcohol use
Some drugs used (antidepressants, etc.)
Number of births and time between births
One of the factors to be considered in the development of obesity is the diet in the first years of life. Studies have reported that the prevalence of obesity is lower in children who are breastfed compared to children who are not breastfed, and the duration of breastfeeding, the type, amount and starting time of complementary foods affect the occurrence of obesity.
In various documents published by WHO and UNICEF (United Nations Children's Fund), breastfeeding alone for 6 months, continuing breastfeeding after the 6th month, starting with complementary foods of reliable and appropriate quality and quantity and continuing breastfeeding for at least 2 years It has been stated that it can reduce the risk of obesity and chronic disease during the period.
What Are Obesity Treatment Methods?
Prevention of obesity is of great importance. Prevention from obesity should start in childhood. Childhood and adolescent obesity paves the way for adulthood obesity. For this reason, family, school and environment should be informed about adequate and balanced nutrition and physical activity. Obesity treatment is a mandatory, long and continuous process that requires the determination and active participation of the individual. The fact that many factors are effective in the etiology of obesity makes the prevention and treatment of this disease extremely difficult and complex. For this reason, a team of physicians, dieticians, psychologists and physiotherapists is required in the treatment of obesity.
The aim of obesity treatment is to target a realistic body weight loss, to reduce the morbidity and mortality risks related to obesity, to give the individual an adequate and balanced diet and to increase the quality of life. A 10% reduction in body weight over a 6-month period provides significant benefits in preventing health problems caused by obesity.
The methods used in obesity treatment are grouped under 5 groups. These methods;
1-Medical Nutrition (Diet) Treatment
Medical nutrition therapy plays a key role in the treatment of obesity. With nutrition therapy in obesity:
It should be aimed to reduce the body weight to the level that should be according to the height (BMI = 18.5 - 24.9 kg / m2). It should not be forgotten that medical nutrition (diet) treatment is specific to the individual. The goals set at the beginning may be the ideal weight of the individual or slightly above the ideal weight.
The slimming diets to be applied should be in compliance with the principles of adequate and balanced nutrition. The aim is to give the individual the right nutritional habit and to maintain this habit.
When the body weight reaches the level that should be according to the height (BMI = 18.5 - 24.9 kg / m2), weight gain should be prevented again and the lost weight should be preserved.
Although the effect of exercise therapy on achieving weight loss is still controversial, it is definitely accepted that physical activity reduces fat tissue and fat in the abdominal area and prevents muscle mass losses that can be seen when dieting. With exercise therapy, weight gain of individuals supporting medical nutrition therapy can be prevented, and weight loss and regaining can be prevented.
It is recommended that adults exercise moderate intensity for an average of 30 minutes each day. This level of activity provides 840kj (200kcal) energy consumption per day. It is aimed to be physically active every day in obese people. Energy expenditure varies according to the body weight and activity intensity of the person.
The basic principles of exercise therapy are as follows:
Type of Exercise; Walking, Increase in Daily Living Activities, Resistance Exercises
Frequency of Exercise; Every day or at least 5 days / week
Duration of Exercise; 40-60 minutes / once a day, 20-30 minutes / 2 times a day
Intensity of Exercise; 50-70% of Maximal Oxygen Consumption
In the obese individual, the most important issues to be considered in the implementation of the exercise program are to increase the energy expenditure while keeping the injury risk at the lowest level. The recommended exercise program should be specific to the individual, fun, applicable and compatible with the daily life habits of the individual.
3-Behavior change therapy
Behavior change therapy under the control of body weight is a form of treatment that aims to positively change or reduce negative behaviors related to eating and physical activity that cause excess weight gain, and to reinforce positive behaviors and become a lifestyle. Steps of behavior change treatment:
Alternative behavior development
Drugs to be used in obesity treatment are not suitable for individuals with mild to moderate excess weight. It is of great importance that the drugs used have been determined to be safe in terms of health, have an appropriate effect on the etiology that causes obesity, have no significant side effects in the short and long term, and are not addictive, and that such drugs must be used under the advice and control of a physician.
In order for the obesity treatment to be successful, the patient must agree to continue medical nutrition therapy and exercise therapy, as well as drug therapy, and come to check-ups regularly.
Surgical approach in obesity is basically divided into two. The aim of bariatric surgery for reducing the energy intake with foods is to reduce the absorption of nutrients in the gastrointestinal system. For this purpose, bypass, gastroplasty, gastric banding, gastric balloon etc. methods are used. The purpose of reconstructive surgery; It is the removal of existing fat tissues localized in various parts of the body. This treatment is esthetic and if the patient does not fulfill the requirements of obesity treatment, fat accumulation occurs again.
How is Obesity Diagnosed?
Body Mass Index (BMI) is widely used to determine obesity based on the obesity classification of the World Health Organization. BMI is a value obtained by dividing the individual's body weight (kg) by the square of the height (in m) (BMI = kg / m2). BMI is used to predict body weight according to height and does not provide information about fat distribution in the body. According to WHO, the international obesity classification is given in Table 1.
Underweight (underweight): <18.50
Extreme weakness: 16.00-16.00
Moderate underweight: 16.00-16.99
Mild weakness: 17.00-18.49
Bulk, slightly obese, overweight: 25.00-25.00
Before being obese (Pre-obese): 25.00-29.99
Fat (Obese): 30.00 - 30.00
Fat I. Degree: 30.00 - 34.99
Fat II. Degree: 35.00 - 39.99
Fat III. Grade: 40.00>
In recent years, researchers have focused on the region and distribution of fat in the body rather than the total amount of fat in the body. This is because the region and distribution of fat in the body is associated with the morbidity and mortality1 of diseases. Regional fat distribution varies genetically in men and women. In Android type (male type) obesity, fat accumulates in the upper part of the body (apple type), waist, upper abdomen and chest abdomen and under the skin. In gynoid type (female type) obesity, fat accumulates in the lower part of the body (pear type) buttocks, thighs, legs and under the skin.
According to WHO, if waist / hip ratio is more than 0.85 in women and 1.0 in men, it is accepted as android type obesity. Although waist / hip ratio is used in determining this distribution, waist circumference measurement alone is used as an important and practical indicator in the distribution of fat in the abdominal region and deterioration of health. The accumulation of fat in the abdominal area and internal organs causes insulin resistance. Insulin resistance is the most important factor in the relationship between obesity and Type 2 Diabetes, hypertension, dyslipidemia, and coronary artery diseases. A waist circumference measurement of 94 cm in men and 80 cm and above in women is associated with the risk of disease.
Sex Risk (Warning limit)
Male> 94> 102
Female> 80> 88
There is no specific classification in children and adolescents as in adults, there are different approaches in the definition of overweight and obesity. One of the most frequently used methods is the use of percentile and / or z-score values at the individual and social level. However, the World Health Organization published growth standards for 0-5 years old children in 2006 and growth reference values for 5-19 age group children and adolescents in 2007. Thus, BMI values by age in children and adolescents have started to be used in the classification of overweight and obesity.
Tables recommended by WHO to be used in the classification of overweight and obesity in children and adolescents are given in Annex-2 and Annex-3. According to these tables, overweight in children under 5 years old is> +2 SD or> 97. percentile (percentile), obesity is defined as> +3 SD or> 99th percentile. In children and adolescents aged 5-19 years, overweight is defined as> +1 SD or> 85th percentile, and obesity as> +2 SD or> 97th percentile.
What are the Health Problems Caused by Obesity?
Obesity;It causes many health problems due to its negative effects on body systems (endocrine system, cardiovascular system, respiratory system, gastrointestinal system, skin, genitourinary system, musculoskeletal system) and psychosocial status.
The relation of obesity with various diseases is known, and its effect on increasing morbidity and mortality has also been revealed. Overweight is responsible for more than 1 million deaths and 12 million life years of illness in the European Region each year.
Insulin resistance - Hyperinsulinemia
Type 2 Diabetes Mellitus (Diabetes)
Hypertension (high blood pressure)
Coronary artery disease
Hyperlipidemia - Hypertriglyceridemia (Raised Blood Fat)
Gall bladder diseases
Some types of cancer (gall bladder, endometrium, ovarian and breast cancers in women, colon and prostate cancers in men)
Excessive hair growth
Increased risk of surgery
Mental problems (such as Anorexia (not eating) or Blumia nervosa (not taking advantage of the food they vomit), Binge eating (binge eating), night eating syndrome or trying to get psychological satisfaction by eating more)
Skin infections, fungal infections in the groin and feet, especially due to excessive subcutaneous adipose tissue as a result of frequent weight loss and gain.
You can ask Mediline Hospital General Surgery Department Specialist teams about obesity and ask for suggestions about your question. You can make an online appointment with our physicians or get information by calling +90 (424) 237 11 11.
Important Note: The content of the page is for informational purposes only. Please consult our physicians for diagnosis and treatment.