Obesity and Obesity Treatment
Obesity is the state of excessive accumulation of fatty tissue in the body and must be treated effectively.
BMI (Body Mass Index) value, which is gained by dividing the weight to the quadrate of height (kg/m²), is currently being used to evaluate obesity. The point that needs to be kept in mind here is that BMI is an anthropometric measurement. In principle BMI value only provides an individual’s height-weight ratio, it doesn’t show the fat percentage of that individual’s weight. Therefore BMI value doesn’t reflect body composition, cannot differentiate fatty and fat free body mass and doesn’t give any idea about the individual’s condition of physical activity. Another point that should be emphasized here is that all body composition analyzing systems in clinical practice (except X-ray Absorptiometry) make indirect measurements within the preloaded programs. This topic will be discussed later on in detail. Another point about BMI is that this measurement doesn’t allow any exception between sex, age and race. More importantly, BMI also doesn’t show the severity of the disease. It is obvious that we need more objective criteria that shows the severity of diseases associated with obesity and Metabolic Syndrome.
Obesity is a chronic health problem that requires chronic treatment. In order to succeed, a comprehensive concept is required, which includes life style changes and physical activity as well. Alas, this combination is ineffective for the majority of severely obese patients. Many studies concerning the prevention of diabetes show that weight loss rates in the long term achieved with life style changes are below 5%. Another danger awaiting these patients is the weight regain more so than what they lost as a reactional turnaround.
Therapeutical life style changes may yield positive results in the short term for individuals that don’t have serious weight problems, but for individuals with a BMI value above 40, there is insufficient data concerning the positive results of this treatment. The reason of this is both obesity isn’t regarded as a disease by the patients until the last stage, and long term compliance issues.
WHY IS OBESITY TREATMENT IMPORTANT?
Today, obesity is a global health problem that threatens the entire world. With its comorbidities and possible health problems that may show up later on, obesity causes significant increase of healthcare costs, organ loss and deaths.
In all components of Metabolic Syndrome, preventing the disease is easier and cheaper than treating it. What needs to be kept in mind here is that life style changes and compliance with healthcare professionals is an indispensable combination. Because of this, obesity treatment should be planned as a long term treatment at the beginning. The points that need to be emphasized in this plan are:
-Obese individuals may decide on therapy for cosmetic-aesthetic reasons and not for health reasons.
-Dividing the treatment to levels and providing the patient with a sense of achievement are very important to sustain motivation. In principle, this concept applies for both diet and behavioral strategies, as well as for programs to increase physical activity.
-Restriction and monitoring must not be the focus of the treatment.
However, the facts shown below, which are supported by scientific guidance should also be known:
In the past quarter century, many clinical studies have focused on prevention the progression of type 2 diabetes. The aim of all these studies was weight control.
In these studies;
-Patients were not homogenized according to their insulin reserves and insulin activity.
-The environment patients were living in and the presence of ‘obesogenic environment’ were not questioned.
-The patients were regularly reminded that they are in a clinical study.
-The patients were periodically provided with informatory/awareness raising meetings and psychological support.
Against all these, effective weight control rate in 3 years was below 5%. If science is our guide, then what science tells us is that we have been unsuccessful about prevention of diabetes progression and weight control with traditional methods. As a matter of fact, surgical treatment appeared because of these reasons.
Emphasizing surgery here doesn’t mean to criticize life style changes in any way. The purpose is to present the rate of patients who could successfully apply life style changes in the long term, and to stress that we need more effective treatment methods in our fight against Metabolic Syndrome pandemic which threatens the entire world.
Metabolic Surgery Association accepts explaining all aspects of surgical treatment of Metabolic Syndrome and especially type 2 diabetes to our people and to all health care professionals as its duty.