Obesity is defined as excessive fat storage in the body. As this problem increases, it brings with it numerous diseases ranging from respiratory failure to heart problems. The Body Mass Index is checked to see if the person is obese. The value of the square meter in height is divided by the weight and represents the Body Mass Index.
The rate of body fat in men is 25 percent; and over 30 percent of women are associated with obesity. Individuals need daily energy that varies according to age, sex, job, genetic and physiological characteristics and disease status. Keeping the energy consumed and the energy consumed in balance is of great importance for having a healthy body.
Daily energy intake is more than the energy consumed, the body is stored as fat and causes obesity formation. As a result, quality of life and duration of life are adversely affected and social health is at serious risk. In addition, the burden on insurance systems is increasing day by day.
MEDISTATE OBESITY CENTER CHOOSING PERSONAL TREATMENT METHODS
Detection and elimination of the disease-causing factors in the treatment of obesity is essential for a successful outcome. Otherwise, the weight given back quickly and problems are repeated. In the treatment of obesity, a 10 percent decrease in body weight over a 6-month period makes an important contribution to the prevention of other problems caused by the disease. However, as long as the causes of the disease are not removed, the patients will regain their weight again and a sustainable recovery cannot be achieved. In Medistate Obesity Center, different medical units work together and determine the treatment methods after determining the reasons that cause the patient to be obese. In this system, which is also called as multidisciplinary approach; Endocrinology and Metabolic Diseases, Nutrition and Diet, Obesity Surgery, Physical Therapy and Rehabilitation, Psychology specialize in evaluating the patient and the treatment process is shaped.
THE ROLE OF ENDOCRINOLOGY AND METABOLISM DISEASES IN THE TREATMENT OF OBESITY
Apart from eating disorders and still life, there are many endocrinological diseases that cause obesity. Therefore, endocrinological examination of obese individuals constitutes the first step of the treatment process. Basically, the earlier the fight against obesity begins, the more permanent the result is. Cushing Syndrome, hypothyroidism, insulin resistance, Polycystic Ovary Syndrome, other genetic syndromes and some secreted hormones can cause obesity. In addition, some metabolic disorders may make it difficult for patients to follow a healthy diet. For all these reasons, endocrinological examination is the first step in the treatment of obesity. After the patient is evaluated endocrinologically, pharmacological treatments are arranged. After this process, according to the patient’s test results, body measurements, hormonal profile and existing diseases, a diet program is planned by the nutritionist and diet specialist. For patients who apply to the Medistate Obesity Center, risk and benefit assessment is also performed surgically and the meeting committee decides the most appropriate treatment plan.
OBESITY FIGHT IS NECESSARY; RIGHT NUTRITION AND DIET
Another important pillar of obesity treatment is proper nutrition and diet. The nutritional habits of the patients are reviewed in detail before the diet program is determined by the Nutrition and Diet Expert; body analysis is carried out to determine the amount of fat, muscle and water in the body and to determine the working speed of the body. Age, gender, physical activity and blood findings are added to these data and a personalized nutrition program is prepared.
In addition, when patients are planned for obesity surgery, a special diet program is applied before and after the surgery, contributing to more successful results.
THE PATIENT IS TRUSTED IN SELF AND TREATMENT
In addition to the physiological problems of obese patients, social and psychological support also plays an important role in the success of the treatment program. Past and unsuccessful diet and exercise attempts; social pressures in work, school, private life, and the lack of self-confidence created by all of these are among the factors that make it difficult to treat obesity. In the treatment of obesity, the patient must first believe in himself and the program. Therefore, social and psychological support in permanent weight control is as important as other treatments. Medistate Obesity Center aims to achieve a sustainable weight control by providing the patient’s motivation in psychological and social aspects along with other disciplines.
DRUG THERAPY IS NOT ENOUGH
Drugs used to prevent obesity are never a treatment in itself. It is only given to the patient as a complement to the treatment. Because obesity drugs are inadequate in treatment and their effectiveness is extremely limited.
PHYSICAL THERAPY MAKES WEIGHT CONTROL CONTINUOUS
In the treatment of obesity, which requires an interdisciplinary program of treatment, physical therapy also provides significant benefits. In obesity rehabilitation, the patient is evaluated by a physical therapy and rehabilitation specialist and then the treatment is planned. Physical Therapy and Rehabilitation offers advantages such as protecting the musculoskeletal system and preventing joint diseases that may cause obesity as well as losing weight. Obesity rehabilitation is planned according to the personal characteristics of the patient after the medical treatment of obesity is planned and evaluated by the metabolism experts and the treatment program is drawn under the guidance of a dietician. While the patient is in the diet program, the treatment program for the musculoskeletal system is organized in two stages: Phase I and Phase II. The Phase I program includes the period in which the patient is passive and the treatment system is active. Phase II period consists of active exercises of the patient. Exercise programs are carried out regularly in parallel with the patient’s medical treatment.
WHEN IS OBESITY SURGERY PREFERRED?
Body mass index is over 40 and patients who can not lose weight despite regular diet and exercise can be used as a treatment method. In addition, the body mass index is between 35-40 and obesity-related hypertension, diabetes or sleep apnea patients with additional diseases such as obesity surgery is applied.
Obesity surgeries, patients to lose weight, have a more fit image, as well as hypertension, diabetes, high blood fats, elevated uric acid, such as life-threatening and disrupting the organs of the blood values to get rid of. In tube gastric surgery, some patients may recover their weight over time due to eating impulses, but after obesity surgery, it becomes difficult for the patient to return to his previous weight. In order to avoid losing weight, the physical activities of the patient should be transformed into a lifestyle. In order to prevent diabetes, it is of utmost importance that the weight given is not recovered.
CONDITIONS FOR OBESITY SURGERY
Patients with severe psychiatric problems
Patients who cannot achieve postoperative compliance
Patients with substance and alcohol addiction
Patients with a condition that prevents them from receiving anesthesia.
ADVANTAGES OF OBESITY SURGERY
Obese patients with hypertension problems have serious improvements in postoperative blood pressure measurements. 60 to 70 percent of patients stop taking blood pressure medications.
Serious improvements in blood sugar levels occur in patients with type 2 diabetes. More than half of the patients can stop using antidiabetic drugs.
After surgery, a significant reduction in the risk of heart disease is observed.
Sleep apnea problems due to overweight are improving.
Respiratory system problems are reduced. Patients’ quality of life is improving.
WHICH METHODS ARE USED IN OBESITY SURGERY?
Stomach Band, Tube Stomach and Gastric Bypass methods are used in obesity surgery. Prior to the operations, a diet program is being created to reduce the patient’s body fat, protect muscle tissue and prepare for treatment after surgery.
Gastric band operations are performed by laparoscopic method. A small stomach pocket is formed by a band placed 3-4 centimeters below the entrance of the stomach. The band is adjustable so that the band can be increased or decreased according to the patient’s follow-up. To do this, a port is placed under the skin. Belt slippage, belt erosion, swallowing problems, belt damage and port location problems may be post-operative problems.
Tube gastric surgery is the most preferred of obesity surgery operations. Surgery can be performed successfully with laparoscopic method. A large part of the stomach is removed and about 25-30 percent of the total volume of the stomach remains. In surgery, the upper part of the stomach called the fundus is removed. Therefore, ghrelin levels, which are secreted from the stomach fundus and are the hormone of appetite, decrease and postoperative appetite control is easier in patients. Although there is a decrease in stomach capacity in this surgery, there is no deterioration in stomach functions. In addition, the risk of ulcers in the stomach is reduced.
Gastrik Bypass ameliyatında, mide girişinde yaklaşık 25-30 cc’lik mide hacmi oluşturuluyor ve mideden 100-150 santimetre uzaklıkta bir incebağırsak bölgesi bu cep ile birleştiriliyor. Bu ameliyat yemeyi kısıtlarken, emilimi azaltıyor. Teknik olarak daha zor bir ameliyat olan Gastrik Bypass’ın riskleri de nispeten yüksek ve geri dönüşümsüz bir ameliyat. Uzun dönem sonuçları tüp mide ameliyatı ile benzerlik gösteriyor; bu nedenle günümüzde tüp mide ameliyatı biraz daha fazla tercih ediliyor.