Obesity is often described as excessive fat accumulation. The most commonly used measure of body fat is the Body Mass Index. (BM). BMI is calculated by dividing a person's weight in kilograms by the square of their height in meters.
Body Mass Index (BMI) = weight (kg) / height 2 (m2)
BMI <18.5 Under normal weight
BMI> = 18.5 - 24.9 Normal weight
BMI> = 25 - 29.9 Overweight
BMI> 30 Obesity
30- 34.9 Class 1 Obesity
35-39.9 Class 2 Obesity
40 and above Class 3 Obesity (Morbid Obesity)
BMI> 50 Super Obesity
A fat cell is an endocrine cell, in other words, a hormonal system cell, and fat tissue is an endocrine organ. This tissue secretes several substances that affect the body. An increase in adipose tissues or obesity increases the amount of circulating fatty acids as well as inflammatory reactions. This causes insulin resistance, which is the basis for diabetes.
Nutrition is a rather complex process that includes the smell, taste, and warmth of the food, cognitive and emotional stimuli, and metabolic mechanisms that send signals to the brain to start and stop eating. In recent years, it has been discovered that some substances give signals to the brain to eat more.
Due to malnutrition and changing lifestyle habits, obesity rates have increased rapidly around the world after the 1960s, and efforts to stop the increase are still declining today. the excess weight ratio of more than 50% in Turkey, the report said. In other words, one in two people is overweight or obese. With this rate, our country is approaching a peak among European countries. In the US, the situation is even worse. 69% of the population is above normal weight, so two out of three people are at risk of this disease, obesity. Given the food distribution, the burden of the disease is quite severe globally.
It would not be wrong to say that obesity is a disease because various hormones and problem-related mechanisms are involved, including hunger hormones. According to American statistics, more than 112,000 obesity-related deaths occur annually. The big picture of obesity is the basis of more than 30 chronic diseases such as type 2 diabetes, high cholesterol, high blood pressure, gallstones, cardiovascular diseases, fatty liver syndrome, sleep apnea, acid reflux, urinary incontinence, coronary insufficiency, joint. diseases, asthma and other respiratory diseases, birth defects and even various types of cancer.
Unfortunately, overweight patients often face discrimination and bullying. Obesity should be considered as a disease and negative perceptions among the public should be corrected.
The main cause of obesity is excessive food or calorie intake. Unfortunately, fast food consumption, which includes a lot of fat and calories and soda, is very popular among children. In addition, products applied by industry such as carbohydrate-based nutrition and fructose syrup are especially threatening young people.
WHAT IS THE TREATMENT OPTIONS?
Professional weight loss programs often include low-calorie diets, increased physical activity, and behavior modification techniques. However, lifestyle changes alone are not effective and sufficient.
The drug used for weight loss does not play an important role as a medical treatment for obesity in the long run. The appetite-reducing medication may help lose weight initially, but most patients who have applied for weight loss programs without surgical intervention have been observed to regain lost weight within 5 years.
Weight loss surgery, also called bariatric or metabolic surgery, has been practiced as a treatment for people who have been overweight for nearly 50 years. when treatments and diets are not working. The results of our laparoscopic (closed) weight loss surgeries are quite satisfactory.
WHO CAN NOT TAKE WEIGHT SURGERY?
Those who are psychologically unstable and severe eating disorders
Those with serious systemic diseases such as liver cirrhosis, serious respiratory diseases, diseases that increase the risk of bleeding and infection, and serious heart diseases
Patients over 65 years old
WEIGHT RESOURCES SURGERY
Two of the most common surgeries are laparoscopic gastric bypass and sleeve gastrectomy.
Sleeve gastrectomy can be described as a restrictive method and basically involves reducing the stomach. This procedure is performed laparoscopically while the patient is under anesthesia, by making small holes in the abdomen without making large incisions.
The stomach decreases by removing most of it, including the part that releases hunger hormones. The result is a tube-like structure with a volume of 100-150 ml. This is the closest method to human physiology.
Gastric bypass is based on reducing the size of the stomach to reduce food intake and shortening the way the food goes in the small intestine, the way to absorption. This surgery limits both the amount of food taken and absorption.
This procedure lowers the stomach to about 20-40 ml. to reduce food intake. As a result of the operation, food bypasses most of the stomach, duodenum and jejunum, so the absorption of food, especially foods high in calories and sugar, is prevented.
After ingestion, food comes from the esophagus to the small stomach and goes directly into the small intestine. In other words, the food bypasses the parts of the digestive system responsible for absorption, the large stomach, duodenum, and jejunum and passes directly into the small intestine.
This surgery involves sewing one or more layers in the stomach to reduce the size of the stomach without removing any part of the stomach or intestines. Therefore, unlike arm gastrectomy or gastric bypass, the operation is reversible. However, sleeve weight is not as effective as a gastrectomy or gastric bypass for weight loss. People who do not have extremely BMI and do not want an incision in their stomach should prefer this surgery.
METABOLIC SURGERY (For Diabetes)
Loop Bipartition Surgery (Loop Bipartition Sleeve Gastrectomy)
This is a type of surgery performed as a treatment for uncontrolled type 2 diabetes associated with obesity. This surgery involves first creating a large gastric "cuff" or "tube" and then anastomosing part of the small intestine close to the exit of the newly formed stomach. Thus, food and drink pass both normal and short cut. Thus, blood sugar is taken under control and the patient loses weight.
Roux en Y Transit Bipartition (Sleeve Gastrectomy with Roux en Y Bipartition)
This surgery involves creating a large gastric "sheath" or "tube" and removing part of the small intestine. Then the tip close to the large intestine is anastomosed to the exit of the newly formed stomach. The upper end is anastomosed to a point close to the large intestine. Thus, blood sugar is taken under control and the patient loses weight.
Duodenal key or biliopancreatic diversion is a weight loss surgery that reduces the volume of the stomach to greatly restrict stomach intake and absorption. This procedure may be a surgical option for super obese patients with BMI above 50 and those who have already had arm gastrectomy but have lost the lost weight. It can also be recommended for patients with uncontrolled diabetes.