What is Obesity?
The condition of unhealthy fat accumulation in the body is called obesity and these people are obese or obese. For the evaluation of chilliness, a system of proportioning height and weight with a special formula called body mass index (BMI) or body mass index (BMI) is used. Today, obesity is observed in approximately 1/3 of adults and 15% of children and adolescents between the ages of 6-19.
HOW IS THE BODY-MASS INDEX CALCULATED?
Body weight (kg)
Height × Height (in meters)
For example; If a 135 kg person is 180cm tall
Body mass index = 135 / 1.80 * 1.80 = 135 / 3.24 = 41.66.
HOW IS THE BODY-MASS INDEX (BMI) EVALUATED?
BMI VALUE, STATUS
Under 20 Kg / m2 Weak
Normal Weight Between 20-24.9 kg / m2
Between 25-29.9kg / m2 Slightly obese (overweight)
Between 30-34.9 kg / m2 Moderately obese (I degree)
Between 35-39.9 kg / m2 Severe obesity (II degree)
Over 40 kg / m2 Very severe obese (III degree), Morbid Obese
Obesity or obesity causes?
Excessive food consumption, consumption of foods rich in calories and fat causes obesity. Lifestyle: a sedentary lifestyle and away from sports prepares the ground for obesity.
Obesity Consequences
- The risk of chronic heart disease increases.
- The risk of atherosclerosis increases.
- Hypertension risk increases 3 times compared to non-obese people
- Steatosis (fatty liver) and steatohepatitis are more common.
- Obesity increases the risk of fatal stroke.
- Increased risk of gallbladder and prostate cancer in obese
- Gallstones are 7 times more common in obese people.
- Reflux esophagitis and hiatal hernia are more common.
- The risk of type 2 diabetes (type 2 diabetes) increases.
- It can cause depression and gout.
- Cycle disturbances may occur
- Libido and potency may decrease
- The risk of colon, rectum and prostate Ca is increased in men.
- Fertility may be reduced
- Polycystic ovary syndrome can be seen
Is there a relationship between obesity or obesity and cancer?
- Yes, it is known that obesity or obesity and cancer disease are directly related with scientific evidence. Especially; It is known that uterine cancer, bowel cancer, breast cancer, kidney cancer and esophagus cancer are associated with inactivity, obesity or obesity at a rate of 25-30%. In some studies, a relationship between ovarian cancer, gallbladder cancer and pancreatic cancer has also been determined.
- It is known that even 5-10% weight loss of overweight or obese patients provides significant health benefits.
- In the studies conducted in the USA, it has been determined that the share of obesity or obesity in cancer is around 3% and cancer related deaths are associated with obesity or obesity at a rate of 15-20%.
- Sudden changes in hormones such as estrogen, progesterone, androgens and insulin are thought to increase the tendency towards cancer.
Is obesity or obesity life-threatening?
Life is threatened in obese or obese people. With the Edmonton Obesity Classification System (EOSS), which is one of the widely used systems in this regard, it is known that the risk of death arises with the increase of the score.
Stage 0: no risk factors (blood pressure, diabetes) related to obesity
Stage 1: presence of mild risk factors (borderline high blood pressure, impaired hunger sugar, elevated liver enzymes) and symptoms (shortness of breath, joint pain, weakness) related to obesity
Stage 2: the presence of chronic diseases related to obesity (high blood pressure, type II diabetes, sleep apnea, joint disorders, reflux disease, polycystic ovary syndrome, anxiety disorder)
Stage 3: presence of obesity-related organ disorders (heart infarction, heart failure, complications due to diabetes, advanced joint disorders and life-limiting diseases)
Stage 4: presence of severe organ disorders due to obesity
In 2011, Raj Padwal et al. They compared the periods 1988-1994 and 1999-2004 in their study on 8,143 patients over the age of 20. While 77% of the population was in the Stage 1-2 obese class in the 1988-1994 period, it was determined that 90% of the population was in the obese class in the 1999-2004 period. It has been determined that obese patients with Stage 2-3 have a significantly higher risk of death compared to Stage 0-1.
OBESITY TREATMENT
IS THE SURGERY SOLUTION?
TO WHOM?
According to international criteria, obesity surgery can be recommended to anyone with a body mass index above 40 AND to people with a body mass index between 35-40 but with a serious disease (diabetes, hypertension, cardiovascular disease, joint diseases, etc.). Behavioral shaping, exercise prescription, diet etc. aids should be offered.
WHICH SURGERY
Nowadays, although surgical methods for obesity have been diversified, it is the right choice to choose the appropriate surgery for the patient by evaluating the patient’s condition, preference, risk factors, etc.
Where and how should Morbid Obesity Surgery be performed?
Morbid Obesity Surgery is a team effort. The main purpose of teamwork is to ensure that a correct surgical procedure is applied to the right patient by the right team. Preoperative examinations, examinations and interviews are very important. During these procedures, the underlying diseases of the patient are revealed and the unfortunate that may occur after surgery is minimized. Obesity surgery should be done in a fully equipped hospital. This hospital should be able to provide intensive care, respirator support when necessary.
What is the Risk of Surgery?
Morbid obesity patients have higher risks than other patient groups. However, complications in this patient group are not as high as expected. The problems commonly reported in centers where bariatric surgery are performed are approaching the rates observed in patients with normal weight. The most important reason for this is that this patient group is seen more and more frequently, the techniques are getting settled, the technology has developed and the experience of the centers that perform obesity surgery has increased. Death rates due to obesity surgery are below 1%. While there are no deaths in many centers, some centers give results like 2 in 1000.
The most effective way to prevent the problems that occur during bariatric surgery is to be prepared in advance and to make a good risk analysis. It is the most important step that patients are entrusted to the care of an anesthesiologist who can solve obesity-related problems before and during the surgery and has received special training in this regard. Procedures should be performed in a center with a fully equipped and intensive care unit. Obesity surgery is a team work.
