Morbid Obesity Treatment in Turkey

Morbid Obesity Treatment in Istanbul

Morbid obesity is a type of obesity with a body mass index (BMI) of 40 kg/m2 or higher. This type of obesity has gained more attention as a health issue in the 21st century. Its diagnosis and progression are as follows:

Although the exact years of the first diagnosis of morbid obesity are not known, it is known to have increased in the early 21st century. Among the reasons for this increase are many factors, such as genetic factors, inadequate physical activity, consumption of high-calorie foods, stressful living conditions, and hormonal imbalances.

The development of morbid obesity is rapidly increasing, especially in developed countries. According to the World Health Organization (WHO), since 1975, the prevalence of obesity worldwide has tripled, and in 2016, more than 13% of adults over the age of 18 had a BMI that could be classified as morbid obesity.

There are various methods for the prevention and treatment of morbid obesity. These methods include diet and exercise programs, obesity surgery, cognitive behavioral therapy, and medication. However, since the effects of morbid obesity can be serious and long-term, early diagnosis and treatment are crucial.

What Are The Harmful Effects Of Obesity?

Obesity is a serious problem that affects the quality of life and leads to health problems for many people. The accumulation of fat in the body gradually increases and eventually becomes a problem that cannot be solved only by diet or exercise. Instead of seeking quick solutions to lose excess weight, it is necessary to make a permanent lifestyle change and manage this process with professional support.

The right approach to fighting morbid obesity, in particular, is to seek the support of a nutrition expert and doctor, engage in regular exercise, and adopt a healthy lifestyle. However, the harmful effects of obesity are not limited to the body alone. Excess weight can also have psychological effects.

So, what are the harmful effects of obesity? First of all, it can lead to a lack of motivation and self-confidence. It can cause social isolation due to reasons such as the inability to participate in physical activities and staying away from social events. In addition, overweight people may experience pain and discomfort in their joints, especially in their knees. This can make it difficult for them to perform daily activities that require mobility.

Back pain and spinal pain are also common problems due to large breasts. In addition, obesity is also associated with difficulty breathing and a constant feeling of fatigue. Difficulty climbing stairs, an inability to run, and struggling with physical activities such as brisk walking are some of the problems caused by obesity.

What Are The Associated Diseases Caused By Obesity?

While many people may be aware of the negative effects of obesity on health, they may not have enough information about how serious of a disease it can be. Obesity is a condition where the body weight is higher than normal, and it can lead to many health problems. Additionally, obesity is also a leading cause of many diseases.

• • Insulin resistance
  • Type 2 diabetes
  • Hypertension
  • Coronary artery disease
  • High blood lipids, such as hyperlipidemia and hypertriglyceridemia
  • Metabolic syndrome
  • Gallbladder disease
  • Cancer (including gallbladder, endometrium, ovary, breast, colon, and prostate)
  • Osteoarthritis
  • Stroke

• anadaSleep apnea
• Fatty liver disease
• Asthma
• Respiratory diseases
• Pregnancy complications and anomalies
• Menstrual irregularities
• Excessive hair growth
• high risk of surgical complications
• Social maladjustment
• Skin infections and fungal infections in the groin and feet (which may occur due to frequent weight gain and loss)
• Musculoskeletal problems

Furthermore, obesity can increase the risk of cancer. Specifically, there is a high risk of gallbladder, endometrial, ovarian, breast, colon, and prostate cancer. However, other health problems caused by obesity include osteoarthritis, stroke, sleep apnea, fatty liver disease, asthma, respiratory diseases, pregnancy complications, menstrual irregularities, excessive hair growth, high surgical complication risk, social maladjustment, and skin infections.

What Is The Weight Limit For Morbid Obesity?

Body mass index (BMI) is the most commonly used measure in the classification of obesity. BMI is calculated by dividing a person’s weight by the square of their height. In medical classification, a BMI of 18.5–25 kg/m2 is considered normal weight. However, it should be noted that a BMI between 25 and 30 kg/m2 indicates overweight, a BMI between 30 and 40 kg/m2 indicates obesity, and a BMI over 40 kg/m2 is classified as morbid obesity.

What Is Morbid Obesity? Who Is Deemed Morbidly Obese?

Morbid obesity is a type of obesity seen in individuals with a BMI of 40 or higher. BMI is used to calculate a person’s weight according to their height, and a BMI between 18.5-24.9 is considered normal. Morbid obesity poses a more serious health risk than other types of obesity and is a risk factor for many diseases. These diseases include heart disease, diabetes, high blood pressure, sleep apnea, respiratory problems, joint problems, and depression.

Morbid obesity can be controlled with appropriate treatment methods. The first treatment option is a lifestyle change supported by diet therapy and exercise. This treatment includes reducing calorie intake and increasing physical activity. However, due to the severity of morbid obesity, this treatment option may not be sufficient and may fail in some patients. In this case, obesity surgery options may be considered.

Is There A Cure For Morbid Obesity?

The treatment for morbid obesity requires a personalized approach and may vary depending on each individual’s unique situation. Therefore, the treatment plan should be prepared by considering the individual’s unique condition and goals. In collaboration with a healthcare professional, a treatment plan can be developed based on the underlying causes, and the management of health problems related to obesity can be targeted.

Treatment of morbid obesity typically requires the implementation of various strategies together. These strategies include:

• Healthy lifestyle changes: Lifestyle changes such as regular exercise, developing healthy eating habits, getting enough sleep, and avoiding stress are essential in the treatment of morbid obesity.
• Behavioral and psychological therapy: Behavioral and psychological therapies play a significant role in combating obesity. These therapies provide support for changing a person’s lifestyle and diet.
• Medications: Medications can be used in the treatment of morbid obesity. These drugs change the body’s metabolism or reduce appetite to increase weight loss.
• Surgical procedures: In some cases, surgical procedures may be required for the treatment of morbid obesity. These procedures may include gastric bypass or stomach reduction.

The treatment of morbid obesity is a condition that requires a personalized approach, and each individual’s treatment plan may vary. Therefore, consulting with a healthcare professional for treatment is the best option.

Healthy Lifestyle Changes

Some lifestyle changes can help you manage obesity, improve overall health, and/or lose weight, such as:

Healthy Eating: Maintaining a healthy lifestyle requires healthy eating to be a significant part of our lives. However, how much and what types of foods we eat are also crucial. According to health professionals, consulting a registered dietitian or nutritionist can be helpful for a healthy eating model. Healthy eating is also important for those who want to lose weight or maintain a healthy body weight. However, starting with gradual changes to our eating habits may be more effective than quickly changing them. Therefore, it is important to talk to your healthcare provider about gradually reducing your daily calorie intake and creating a plan to eat healthy foods.

Physical activity is one of the cornerstones of a healthy lifestyle. It has positive effects on both physical and mental health. Physical activity can help with weight loss, reduce the risk of cardiovascular disease, support muscle and bone health, reduce stress, and even strengthen your immune system. However, it is important to determine whether physical activity is suitable for you before starting any exercise program. Your healthcare provider will advise you on the type and amount of physical activity that is best for you. An exercise plan can be created taking into account age, gender, overall health status, and other factors.

Healthy Sleep: Having a healthy sleep schedule is one of the most important elements of a healthy lifestyle. If you do not get enough sleep or have sleep disorders, your risk of obesity may increase. Therefore, it is important to control your sleep schedule for a healthy lifestyle and receive treatment for sleep disorders. The relationship between sleep deprivation and obesity is due to hormonal changes. When sufficient sleep is not obtained, the levels of the hunger hormone ghrelin increase and the levels of the satiety hormone leptin decrease. This can cause the body to want to eat more.

Weight gain is one of the most frequently mentioned negative effects of stress.Chronic stress can cause us to accumulate body fat by disrupting our hormone levels. Therefore, stress management should be an important part of our lives. Methods such as meditation, yoga, or breathing exercises can be used for this. Additionally, having a regular sleep schedule and exercise routine are also important to reduce stress as much as possible. Remember, reducing stress not only helps with weight loss but is also beneficial for our overall health and well-being.

Behavioral And Psychological Therapy

Obesity is a disease that brings many physical and psychological difficulties. Health professionals can help you overcome this problem by recommending weight-loss programs. These programs include a weight-loss plan prepared by a specially trained healthcare professional.

Along with obesity, most people experience mood disorders such as depression and anxiety. Therefore, health professionals can offer psychological therapy recommendations by considering your mental health as well.

The different types of behavioral and psychological therapies used in the treatment of obesity are as follows:

Motivational interviewing is a type of therapy that provides motivation to discover your own strengths and make changes. It is designed for behavior change.

Cognitive-Behavioral Therapy (CBT): The therapist or psychologist works with you to change harmful or unhelpful thought and behavior patterns. This therapy takes place in multiple sessions. It helps you gain a different perspective by talking and asking questions.

Dialectical behavioral therapy (DBT): It can help if you have difficulty regulating your emotions or exhibit self-harm behaviors.

Interpersonal Psychotherapy (IPT): This therapy focuses on improving the quality of your interpersonal relationships and social functioning.  The goal is to support the treatment process by reducing stress.

The treatment of obesity requires considering not only your physical health but also your mental health. Weight loss programs and psychological therapy offer different approaches to overcoming the disease. By following the recommendations of your health professional, you can achieve a healthier and happier life.

Medications

Obesity is a serious condition that can lead to many health problems. While some people may lose weight through healthy lifestyle changes, it may not be sufficient for others. In this case, healthcare professionals may recommend FDA-approved weight-loss medications. However, medications are not recommended as a treatment for morbid obesity on their own.

Weight-loss medications work by affecting the brain or gastrointestinal system. Some reduce appetite by altering the brain’s hunger drive, while others prevent the absorption of fat in the intestines. For example, diethylpropion, phendimetrazine, lorcaserin, naltrexone/bupropion, and liraglutide are medications that affect the brain. Orlistat, on the other hand, is a medication that affects the intestines and has fewer side effects than other medications.

However, like other medications, weight loss medications can have different side effects and should not be used by those with certain conditions or using certain medications. Therefore, it is important for everyone to carefully consider weight loss medications and make decisions with their doctors. When combined with healthy lifestyle changes and appropriate exercise, weight loss medications can be an effective treatment for weight loss.

Surgical Treatment

Obesity has become an increasing health problem worldwide. Especially when morbid obesity cannot be controlled by weight loss medications and lifestyle changes, bariatric surgical procedures can be used. Gastric bypass, sleeve gastrectomy, and gastric banding surgeries can be effective in controlling obesity.

How To Calculate Morbid Obesity

Being at an ideal weight is important for maintaining a healthy lifestyle. Healthcare providers use body mass index (BMI) to determine a person’s ideal weight. BMI is calculated by the ratio of your height to your weight, and the optimum BMI range is between 20 and 25. However, certain criteria must be met to have morbid obesity. These criteria include having an optimal body weight range over 100 kilograms based on your gender and height, having a BMI of 40 or more, or having a BMI of 35 or more and experiencing health problems related to obesity.

The BMI scale may not always give accurate results. Therefore, healthcare providers use other criteria to diagnose obesity. One of these is measuring the circumference of the waist.If the waist circumference is more than 35 inches in non-pregnant adults, the risk of obesity is high in women, and if it is more than 40 inches in men, the risk of obesity is high. However, lower waist circumference measurements can be used to determine obesity risk if you are of South Asian, Central American, or South American origin. Therefore, people with a history of obesity may not show a wide waist circumference despite being diagnosed with obesity.

Healthcare providers can also measure skin thickness to diagnose obesity. Skin thickness measurements in areas such as the back of your upper arms (triceps), the front of your upper arms (biceps), under your shoulder blades (subscapular), and above your hip bones (supra-iliac) can help estimate the risk of obesity.

How Is Moribund Obesity Surgery Performed?

Obesity has become a growing health problem worldwide. Particularly when morbid obesity cannot be controlled with weight loss drugs and lifestyle changes, bariatric surgical procedures may be considered. Gastric bypass, sleeve gastrectomy, and gastric band surgeries can be effective in controlling obesity.

Gastric bypass surgery is performed by connecting a small portion of the stomach to the middle part of the intestine. This limits the amount of food the body can absorb and store, making the person feel full with less food. In a sleeve gastrectomy, a large portion of the stomach is removed to create a smaller stomach, which also causes the person to eat less. Gastric band surgery involves placing a hollow band around the upper part of the stomach to create a smaller stomach and a feeling of fullness, leading to less food intake.

However, bariatric surgical procedures have specific risks and benefits. Immediately after the surgery, complications such as infection, bleeding, thrombosis, and cardiac events can occur. Longer-term complications may include malabsorption, vitamin and mineral deficiencies, refeeding syndrome, and dumping syndrome. As a result, before considering bariatric surgical procedures, it is necessary to consult with a healthcare professional and weigh the risks and benefits.

In conclusion, lifestyle changes and weight-loss drugs may not be sufficient to control obesity. In this case, bariatric surgical procedures may be considered. However, it should be remembered that each procedure has different risks and benefits and should be guided by experts.

What Are The Nutrition And Diet Procedures After Morbid Obesity Surgery?

Morbid obesity surgery is just one step in the weight loss process. After surgery, patients need to make changes to their eating habits and follow a specific diet plan. Many patients are provided with a personalized diet program that helps with the post-surgery recovery process, prevents nutrient deficiencies, and aids in weight loss.

First Stage Diet: Liquid And Purified Foods

The post-surgery diet can vary depending on the type of surgery and the patient’s overall health. However, the first stage of the diet usually involves consuming liquids and pureed foods. This stage can last for the first week or two after surgery and is designed to help with the healing of the stomach and intestines while preventing overeating.

During this stage, patients consume foods that are suitable for a liquid diet. These include liquid protein drinks, clear fluids, soup, liquid yogurt and milk, unsalted chicken broth, and herbal teas. Pureed foods consist of soft foods that have been blended or processed into a puree. These include pureed vegetables, soft meats, and eggs.

It is important for patients to consume enough fluids during this stage and to consume liquid foods slowly. Eating small portions and chewing slowly will help with the healing of the stomach and intestines. Carbonated drinks, caffeine-containing beverages, sugary drinks, acidic drinks, and alcohol should be avoided during this stage.

Second-Phase Diet: Soft Foods

After successfully completing the first phase diet consisting of liquid and pureed foods, the second phase diet consisting of soft foods is introduced. This phase lasts for 2–3 weeks after surgery and consists of foods that are easy to digest and do not strain the stomach.

During this phase, foods such as yogurt, boiled vegetables, mashed fruits and vegetables, soft meats, and cooked beans are consumed. High-protein foods such as oatmeal, boiled eggs, and cottage cheese can also be preferred. However, foods that cause gas and spicy foods should be avoided.

In the second phase of the diet, foods should still be consumed in small portions, and at least 30 minutes should pass between meals. Additionally, meals should be chewed slowly and consumed with water.

During this phase, it is important to take multivitamins, calcium, and iron supplements according to the doctor’s recommendations. It is also important to consume sufficient amounts of fluid. Drinking at least 8 glasses of water daily will ensure adequate fluid intake.

The second phase diet is an important step in the recovery process following surgery.Consumption of soft foods enables a gradual progression in the stomach and intestines’ adaptation process. It is important to communicate frequently with a dietitian or doctor, follow the diet plan, and regularly take nutritional supplements during this phase.

Third Phase Diet: Regular Foods

After morbid obesity surgery, patients’ diet plans are divided into three different phases. The first phase includes liquid and pureed foods, while the second phase includes soft foods, and the third phase includes regular foods.

The third-phase diet involves slowly adding normal foods to the patient’s diet. By this phase, six months after the surgery, patients’ bodies have sufficiently healed and are ready to eat normal foods. However, even in this phase, patients may need to change their eating habits. There are rules that must also be followed during this phase:

• Meal size: Patients must keep their meal sizes in small portions. This is one of the fundamental principles of stomach stretching surgery and a rule that must always be followed. It is also important to eat slowly and chew thoroughly during meals.
• Calorie intake: Patients may need to consume a certain amount of calories to reach their ideal weight. Dietitians prepare a customized diet plan based on patients’ body mass indices and metabolisms.
• High protein: After surgery, patients need to pay attention to their protein intake. High-protein foods help wounds heal and help maintain muscle mass.
• Low-fat: The consumption of fatty foods should be limited. This is important to accelerate the weight loss process and reduce body fat.
• Low sugar: The consumption of sugary foods and drinks should be limited. This is important to lower blood sugar levels and accelerate weight loss.

The post-morbid obesity surgery diet plan is designed to help patients change their eating habits. It is important for patients to follow the recommendations of dietitians and adopt healthy eating habits for a successful weight loss process.

Dietary Supplements

Following morbid obesity surgery, it may be difficult to consume adequate amounts of certain nutrients due to changes in nutrient absorption in the body. As a result, people may need to take dietary supplements after surgery to maintain their quality of life.

Protein: Protein is important to support post-surgical recovery and prevent muscle loss. As some morbid obesity surgeries may reduce protein absorption, there is a specific need for protein. Protein supplements can be taken in powder or bar form.

Iron: Iron is important for the production of blood cells, and it is important to consume enough after surgery. Iron supplements can be taken orally or, in some cases, intravenously.

Calcium: Following morbid obesity surgery, there may be a decrease in calcium absorption in the body. Therefore, taking calcium supplements is important. Calcium supplements are usually taken orally.

B12 vitamin: Some morbid obesity surgeries may affect B12 vitamin absorption. B12 vitamin supplements can be taken orally or, in some cases, intravenously.

D-vitamin: D-vitamin is important for bone health.There may be a deficiency of vitamin D in the body after morbid obesity surgery. D-vitamin supplements are usually taken orally.

Post-surgical nutrition after morbid obesity surgery is a lifelong process. Dietary supplements are important to ensure individuals consume adequate nutrients while maintaining their lives. However, it is necessary to consult a healthcare professional before taking these supplements.

Exercises

Exercise is of great importance in addition to nutrition after morbid obesity surgery. However, exercising in the early stages after surgery may be risky and must be done under doctor’s supervision.

During the early stages after surgery, low-impact exercises such as walking and yoga can be performed. However, it is recommended not to exercise for 6 weeks after surgery.

Physical activity should be gradually increased after the initial period. Exercises such as aerobic exercises, treadmill running, swimming, cycling, and resistance training can help increase heart health, muscle mass, and fat loss.

The exercise program should be tailored to the individual and performed in accordance with their post-operative health status. Additionally, regular exercise combined with a healthy diet is the key to success in the treatment of morbid obesity.

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