Although diet and exercise are the first things that come to mind in the treatment of obesity, these are impossible for most people. Intense stress, not having time for oneself, failure after various attempts, and lack of motivation make it increasingly difficult to get rid of excess weight. Of course, obesity is not just an aesthetic problem. It is also the cause of many life-threatening diseases such as hypertension, high cholesterol, triglyceride levels and type 2 diabetes mellitus. The best treatment for this condition called metabolic syndrome can be achieved by reducing weight.
Another condition that develops due to excess weight is fatty liver. Fatty liver may be at a level that can only be detected on ultrasound (hepatosteatosis, hepatomegaly), or in advanced cases, it may also cause increased liver function tests (ALT, AST, GGT) in the blood (steatohepatitis). The increased amount of fat in the liver tissue causes the liver cells to break down, resulting in fatigue, sweating, aversion to everything, and sleep disturbance in the patient, reducing the quality of life. If the cell damage due to fatty liver continues for many years, it causes an increase in the connective tissue called fibrosis and, over time, even causes liver cirrhosis and cancer. 9-10% of liver cirrhosis cases develop due to fatty tissue. As can be seen, obesity is more than a simple weight problem, it is a disease that can end life due to reasons such as coronary diseases, diabetes, hypertension, liver cirrhosis and cancer.
Various diets have been advocated and implemented in obesity for years. When a person consumes more calories than he consumes, this is converted into fat tissue and weight gradually increases. It contains approximately 7000 calories per 1 kg of fat tissue. However, this energy in fat tissue is not an energy store that can be easily used during short-term fasting. Unless accompanied by an endocrine disease, exercise is necessary to melt fat. Exercise increases the body's muscle mass and ultimately the basal metabolic rate. Diet, surgery or endoscopic treatments only reduce the calories taken into the body. In this case, there is a significant decrease in muscle tissue as well as fat tissue, and weight loss stops after a short time. Turn the increase in mobility with decreasing weight into an advantage and continue with appropriate exercise.
Although endoscopic treatments do not bring the person to the ideal weight, they increase the person's motivation and belief in being healthy and fit. In this way, continued weight loss can be achieved. As a result, regardless of the weight loss method, the patient must first be evaluated with a comprehensive examination. For example, if the cause of obesity is hypothyroidism or diabetes, appropriate treatment is essential.
Overeating problem can appear in many ways. If the person is hungry frequently, endoscopic balloon and botox treatments are more useful. However, these treatments are not beneficial for weight gain due to constant snacking or consuming high-calorie foods and carbonated drinks. In this case, it is necessary to regulate the diet.
Endobariatric treatments in obesity:
Stomach botox:
Botulinum, the toxin of the bacterium Clostridium botulinum, causes temporary paralysis in smooth muscles. It has been used in medicine for a long time to correct facial wrinkles. Observing the same effect on the smooth muscles of the stomach reduces the rapid functioning of the stomach and ensures that the person remains full for a longer time. While the stomach contents are completely emptied on average in 4-5 hours, in this case the time extends to 7-8 hours. In order to achieve this, during endoscopic application, botox should not be administered under the mucosa, as is often done, but should be injected into the stomach muscle layer. The application site of Botox in the stomach is the antrum and fundus.
· To whom it can be applied:
o Mildly obese people (those with a BMI of 27.5 - 40),
o Those who aim to lose 10-15 kg
p>o Those with health problems related to excess weight:
§ Type 2 diabetes,
§ Hypertension,
§ High cholesterol level,
§ Sleep apnea,
§ Fatty liver,
§ Sexual problems,
§ Arthritis, joint problems,
o Those who cannot lose weight with diet
· Duration of effect:
o The effect lasts for 4-6 months.
· Sleep again. Can it be used
o Yes
Gastric balloon treatment:
The balloon creates fullness in the stomach and causes hunger. It delays the feeling. The silicone-coated balloon is kept in the stomach by filling it with liquid (Orbera, Reshape, Spatz, Elipse) or air (Obalon). The balloon is placed in the stomach under sedation through endoscopy. 400-700 ml of physiological saline and 2-10 ml of methylene blue are injected into the balloon through a special catheter. Methylene blue allows the situation to be noticed by changing the color of stool and urine in case of any rupture.
Although the length of time the balloon stays in the stomach is usually 6 months, there are also some that can stay for 12 months. In a study published in England, it was observed that an average of 45.7% weight loss was observed in 73 patients as a result of balloon application for 12 months. A similar 36% weight loss has been reported with the balloon (Obalon), which is applied without the use of an endoscope and placed under x-ray light by injecting gas (nitrogen-air mixture). Before the balloon is inserted, endoscopy must be performed to evaluate whether there is a stomach hernia, ulcer, tumor, etc. Apart from the classic single balloons, there is also a double balloon system.
Read: 0
