Today, obesity is a candidate to be the number one health problem all over the world. It is so serious and widespread that we can now talk about an obesity epidemic. Worldwide, 1.5 billion people are overweight and 500 million people are obese. Although it started as a specific problem for the Western world, this disease has now spread all over the world. It is increasing at an alarming rate even in countries suffering from malnutrition and hunger. This condition affects people of all age groups and is even seen in children.
Obesity is mainly based on 2 reasons. The first is the easy access and purchase of foods that are high in calories and fat, poor in vitamins and minerals, but delicious. The other reason is that the energy consumed cannot be spent or consumed as a result of increasing urbanization and transportation and work becoming more and more sedentary. The effects of obesity are extremely severe and fatal. It causes diabetes. High fat content causes blockage in the vessels, triggering heart diseases, stroke and high blood pressure. It increases the risk of uterine, breast and large intestine cancer. It accelerates the development of gallbladder stones. In addition, due to the effect of excess weight on the body, wear and tear and spinal damage develop in all load-bearing joints. It puts pressure on the lungs, making breathing difficult, and can lead to snoring at night and even respiratory arrest. All these diseases and physical effects dramatically reduce the life expectancy of an obese person.
In addition, the mobility difficulties and appearance caused by obesity disrupt the level and quality of social life. Obese people have difficulty finding ready-made clothes, places in transportation vehicles and meeting areas.
In order to correct obesity, which is one of the most important health problems, two factors that cause it must be eliminated. It is the expenditure of accumulated fat and energy through appropriate movement and sports and the reduction of food intake. Implementation of only one of these methods will result in failure.
Energy consumption:
In today's society, transportation is easy and vehicles, and business life generally consists of non-physical activities, so the energy obtained with food cannot be spent. Therefore, people should exercise regularly every day. As a rule, at least 5 days a week for half an hour It is recommended to do sports without breaks. Regular exercise in this way is also very necessary for heart health. In addition, walking as much as possible, walking to nearby places, and using the stairs instead of elevators will be supportive.
Reducing energy (calorie) intake:
The first step in this plan is diet application. Dietary practices that do not cause protein and vitamin deficiencies and are under the control of a dietitian are applied in the first step. The rate of weight loss through diet should not be too fast. Losing at most 1-2 kg per month is an acceptable weight loss rate. Additional disorders may occur if you lose weight faster than this.
Medication applications:
Some medications can be used if the solution cannot be achieved with diet or as additional support to the diet. The safest of these is the drug called "orlistat", which reduces fat absorption from the intestine. Even this medicine can have serious side effects. Other drugs do not have much effectiveness or have serious side effects.
Interventions/Surgeries:
When the methods listed above do not help, more serious interventions may be considered. Some conditions are necessary for the implementation of these initiatives. The person must have a BMI over 40 or over 35 and have an additional systemic disease (diabetes, high blood pressure, heart disease, etc.). Meanwhile, this person is expected to have tried other weight loss methods for at least 6 months.
Interventions or surgeries are basically evaluated under 2 groups.
- Absorption-reducing procedures
- Restrictive (volume-reducing) procedures.
Some procedures consist of combining these two techniques.
The organ that enables nutrients to become usable in the body is the small intestine. Anti-absorptive procedures are basically interventions that cause a part of this organ to become dysfunctional or bypassed. Weight loss is achieved very successfully with these methods. However, serious problems may arise. These include fluid and salt imbalance, vitamin deficiency and diarrhea.
In restrictive (volume reducing) procedures, no action is taken in the small intestine, but the amount of food that can be digested is reduced at the stomach level. Inside of this These include placing a balloon inside the stomach or wearing a gastric band. Additionally, the stomach volume can be reduced by folding the stomach or removing a large part of it. These procedures cause fewer problems than malabsorption procedures performed at the small intestine level.
In some cases, both malabsorption and restrictive procedures can be used together.
Which method for weight loss? Regardless of whether it is used, the person must be willing to do this work, be appropriately informed in order to cope with the problems that may arise after the procedure, and be ready for long-term follow-up after the procedure.
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