Obesity, one of the chronic and complex health problems of our age whose incidence is rapidly increasing, is a metabolic syndrome that occurs due to abnormal and excessive fat accumulation in the body that impairs health and causes many health problems. Obesity is not a simple overweight problem that can be treated with traditional methods, on the contrary, it is a serious clinical disease and a dangerous health problem that carries high health risks. Because obesity is an important risk factor for many diseases.
Body Mass Index (BMI) is used to classify obesity in adults and express the weight per square meter of the body. According to the World Health Organization data, those with a body mass index above 30 are called obese.
The most common causes of obesity are:
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Consuming fast food type foods that are poor in nutrition and rich in fat and calories
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Sedentary life
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Sleeping less: As a result of some hormonal changes caused by insomnia in the body, you may feel hungry and need some high-calorie foods
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Genetics: Genetic makeup can affect how the body converts food into energy and how fat is stored.
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Old Age: As we age, muscle mass decreases and metabolism slows. This makes it easier to gain weight
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It may be difficult to lose the weight gained during pregnancy.
Treatment of Obesity
Treatment of obesity can be divided into several stages: diet-physical activity, medical treatment and surgical treatment. Bariatric surgery is used in cases of obesity where diet therapy or medical treatment accompanied by physical activity do not yield results. Minor surgical procedures such as gastric balloon and gastric botox can also be added to the diet to increase compliance with the diet. The treatment to be applied to the patient should be decided by mutually discussing what the patient wants and expects. For example, a morbidly obese patient cannot reach the desired weight with methods such as gastric balloon or stomach botox. These methods prepare the patient for surgery. But they should be tried as methods that can be used to reduce the risk of surgery.
Gastric balloon:
A silicone elastic balloon is used under direct vision with endoscopic or laparoscopic techniques. It is administered by placing it in the stomach and inflating it with isotonic NaCl colored with methylene blue. The feeling of a full stomach results in a decrease in the release of hormones that create the feeling of hunger and appetite suppression. This is expected to reduce food intake.
Stomach botox:
In the stomach botox treatment, the six-month treatment begins with an injection into the muscle layer in the middle and near the exit of the stomach. Since these muscles are paralyzed for about four to six months, stomach movements and gastric emptying are weakened. Thus, it contributes to weight loss as food leaves the stomach later.
What are the characteristics of the patients to be selected for surgical intervention?
1. Body mass index must be 40 kg/m² and above,
2. If the body mass index is between 35-40 kg/m², diabetes, hypertension, sleep apnea, etc. There must be a comorbid disease such as
3.The patient's age must be between 18 and 60 years old
4.The existing obesity must be at least 3 years
5.The patient must have a hormonal disorder There should be no discomfort
6.There should be no alcohol, drug or medication addiction
7.There should be an acceptable risk of surgery.
Sleeve Gastrectomy
After the surgery, patients are discharged 3-4 days later and can start eating solid food approximately 1 month later.
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