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OBESITY

Obesity is a serious chronic disease affecting millions of people around the world and increasing every day.

Obesity is the second leading cause of preventable death after smoking.

An obese person’s life is significantly more at risk than a person of a healthy weight because obesity increases the likelihood of premature death by 50% to 100%.

Obesity shortens the life expectancy 9, years for women and 12 years for men.

For these reasons morbid obese people must lose weight in order live a long, healthy life.

WHAT IS THE

OBESITY?

The easiest explanation of obesity is accumulation of excess body fat..

Morbid obesity, which is being owerweight in the level of illness, is a continuous disease that can be caused by various factors. Also, it has hereditary, behavioral, social, cultural and environmental effects.

Obesity is composed of physical, psychological, and economic problems and stem from a person’s health conditions.

In a summary morbid obesity is being overweight at a life threatening level.

 

CLASSIFICATION
Obesity Classification (Ministry Of Health And The World Health Organization Resource Is Obtained)
WEAK
BMI < 18.5
NORMAL
BMI = 18.6 ~ 24.9
OVERWEIGHT
BMI = 25 ~ 29.9
I. DEGREE OBESE
BMI = 30 ~ 34.9
II. DEGREE OBESE
BMI = 35 ~ 39.9
III. DEGREE OBESE
BMI > 40

Morbid obesity is being overweight in level of illness and we use the term morbid obese for people with a BMI more than 40% or 35%.

Body Mass Index Calculator
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HOW DOES OBESITY

AFFECTS OUR LIVES?

Obese People have more risk for;

  • Diabetes
  • Joint problems
  • Hypertension
  • Heart disease
  • Bladder problems
  • Some types of cancer (breast, uterine, colon)
  • Digestive disorders (reflux disease)
  • Respiratory problems (sleep apnea, asthma)
  • Psychological problems (depression)
  • Infertility
  • Incontinence

as is at increased risk for disease.

OBESE PEOPLE
  • Are psychologically at risk.
  • May suffer from a negative self-image
  • May suffer from social isolation
  • May experience discrimination
  • May suffer from limited or poor mobility
  • May suffer from fatigue or get exhausted easily
  • May struggle to find a comfortable seat when using public transportation
  • May struggle to perform daily tasks

OBESITY

TREATMENT

The Criterias For Surgical Treatment of Obesity

Patients with these characteristics are candidates for bariatric weight loss surgery:

- BMI = 40 or BMI = 35 with obesity-related conditions such as diabetes, asthma, highblood pressure, Reflux disease or sleep apnea
- Age 18 or older
-Attempted  non-surgical weight loss methods without success
-Comitted to long-term lifestyle changes, including dietry,exercise and medical requirements

Weight Loss Surgery For Obese Teens(Age 12 -19)

- Statistically, more than 80% of overweight children age 12-19 are also overweight in their adulthood. Due to the fact Due to the fact that of the health centers recommend surgical treatment in that age group.

  • With a BMI above 50%
  • With a BMI above 40% and obesity related conditions
  • Completing skeleton growth

  • Being in the level of consciousness to understand and accommodate the procedure, 
  • Having a supporting family
TREATMENTS
  • With a BMI above 30%,
  • With a BMI above 27% and obesity-related conditions,
  • For the patients with a BMI above 50%, as a helpful method during the preparation process to the weight loss surgery
  • Age 18 or older

Not recommended while pregnant, having major stomach hernia,  esophageal damage in the future related to reflux diseases, severe gastritis and ulcer, also for the people taking aspirin or having psychological problems.

The empty ballon inserted in the stomach is filled with either steril saline or air(depends on the type of balloon being used and the preferance of the surgeon). You will have than the feeling of fullness even after eating smaller amount of food.

It helps people to reduce their nourishment by giving a diet and helps them to lose weight.

Stays 6 months in the stomach and  must be avoid to leave more than 6 months. İt provides to people loosing 20-25% kilogram in 6 months.

Complications:

 - First 48 hours you may experience stomach cramps, a sense of nausea and perhaps vomiting.
  - You may also experience a risk of infection, balloon may go down or deflate.

A gastric band operation is a type of weight loss surgery. It involves reducing the capacity of your stomach using an adjustable band so that you can only eat small amount of  food.
The surgeon will make four to five small cuts in your upper abdomen in order to gain access to your stomach. The operator will use small instruments, guided by a laparoscope to place the band around the top part of your stomach.

 

Advantages Complications
  • Lower risks during the operation
  • No reducing or cut in stomach
  • Laparoscopically applied
  • Reversible
  • Adjustable
  • Bleeding, organ injury and infection
  • Sliding or displacement of the band according to malnutrition
  • It may rarely damage to the stomach wall (erosion)

The procedure is performed laparoscopically. The left side of the stomach is removed leaving a smaller sleeve or tube that shaped like a banana.The stomach is reduced by 75%.  This procedure realize by putting 3 lines of punch in both side of the stomach with the help of automatic tools called stapler.There are 2 mechanism for a weight loss in sleeve gastrectomy,When the stomach capacity is around 150 ml and taking small amount of food, it will be full.There will occur a weight loss because of a decreasing food uptake.There will be no hunger feeling because of taking out the stomach tissue which produces Ghrelin known as a hunger hormone.Sleeve gastrectomy is an owerweight operation which is affective in a very short amount of time. %70 of the excess body fat loss in 6 months and 80% in 12 months.

 

Advantages Disadvantages Complications
  • The sensation of fullness increased due to the decrease in stomach volume.
  • There will be a reduced sensation of hunger
  • Performed laparoscopically
  • According to gastric bypass surgery ;
    • It is an easier method of weight loss
    • The operation procedure is shorter
    • Shorter hospital stay
    • Complication rates are lower
    • Conformable method to the physiology.
  • Irreversible
  • The stomach may expand 50%.
  • General complications
    • Allergic reactions to medications
    • Risk of disease transmission related to transfusion  due to blood loss
    • Heart attack, renal insufficiency, urinary infection      
    • Possible death (0,2%)        
  • Specific Complications of Gastric Bypass Surgery
    • Blood clot in leg veins
    • Adjacent organ injury
    • Leakage on stapler line (0,5-7 %)

Gastric bypass surgery helps people lose weight by changing how the stomach and small intestines process the food that people eat. The first step is to make patient’s stomach smaller using staples. The stomach is divided into astomach into a small upper section and a larger bottom section. The top section of stomach is where the food you eat is sent. The second step is the by-pass. The surgeon will connect a small part of patient’s intestine to a small hole in the pouch. The food will travel from the pouch into this new opening into the small intestine. Because of this, the body will absorb fewer calories.

 

Advantages Disadvantages Complications

- Performed laparoscopically
- Quick weight loss
- Patients lose excess body weight at by 2 years after surgery
- There is a low posibility to gain weight for a long time after the surgery.

 

- It is a major operation with serious risks.
- It may cause to anaemia and malnutrition which requires long-term  vitamin and mineral support.
-Gallstone risk may occur due to the fast weight loss.
-Dumping syndrome may occur (vomiting, reflux, diarrhea.

-General complications:
     -Allergic reactions to medications.
     -Risk of disease transmission related to transfusion  due to blood loss.
     -Heart attack,renal insufficiency, urinary infection.
     -Risk of  death (0,2%)

-Specific Complications for Gastric By-pass Surgery
    -Blood lot in leg veins
    -Adjacent organ injury
    -Leakage on stapler line (0,5 – 7 %)
    -Narrowness of the line between stomach and intestine
    -Gallstone formation
    -Dumping syndrome
    -Dehydration
    -Stomach ulcer

 

The procedure is performed laparoscopically. The upper side of the stomach turns to a 100ml tube shape the same as in the sleeve gastrectomy procedure. The tube is then connected directly to the jejunum (lower intestines), approximately six feet from the starting point. This connection bypasses the upper portion of the small intestine (the duodenum) where the body absorbs most of the food's nutrients. When the patient consumes a meal, the food goes directly from the tube to the lower portion of the small intestines. The rest of the stomach is sealed so food is not able to enter it.

 

Advantages Disadvantages Complications
- The procedure is shorter than gastric bypass
- There is a lower risk of post-surgery complications
- Same level of weight loss results and patients may experience relief from symptoms associated with obesity-related health conditions

 

- It is a fairly new type of operation, therefore the long-term effects and results of mini gastric sleeve operation are somewhat unknown. - Reflux ratio is higher than gastric bypass
- The other complications are the same as in the gastric bypass surgery

OBESITY

BEFORE AFTER

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