What is obesity?
Obesity is a complex multifactorial disease and is defined as abnormal or excessive fat accumulation that may impair health. It concerns the calories balance that we use through physical activities and our body’s other energy needs (for example, breathing, digesting food, sleeping) on a daily basis, in relation to the total of those it takes in through eating and drinking. Poor diet, lack of exercise and the modern lifestyle are the main causes of this balance disturbance, however, genetic predisposition (genes) are involved to a significant extent in the appearance of obesity as well.
Is obesity very common?
Today, an estimated 40% of people in the Western world are obese. People who suffer from the clinically severe form of the disease are largely condemned to die at the age of 50-60, due to serious complications from the heavy weight. A clinically severe obese person is twelve times more likely to die than someone with another medical condition and a normal weight.
Obesity in Greece
In Greece, 70% of adults are overweight, 22% are obese and 5% are clinically severe obese. Essentially, a major city in the country is exclusively consisted of clinically severe obese people, a picture that while it seems impressive, unfortunately, it is numerically true. The prevalence of childhood obesity in Greece is the highest in Europe according to the World Health Organization (WHO). A recent study showed that 44% of children aged 10-12 in Greece are overweight and 11% are obese (in contrast to Belgium where the corresponding percentages are 17% and 3.5%). Accordingly, the time devoted to physical exercise per week by Greek students is just 7 minutes compared to 40 minutes for the children from Northern European countries.
What are the criteria that classify a person as obese?
The most accepted classification of obesity up to date is that based on Body Mass Index (BMI). It is defined as a person’s weight in kilograms divided by the square of his/her height in meters (kg/m2). The normal Body Mass Index (BMI) is 18-25. People with a BMI > 25 are overweight while over 30 are considered obese. When the Body Mass Index (BMI) exceeds 35 then we have the morbid or clinically severe obesity (Obesity Class II) and when it exceeds 50, then we have the Obesity Class III (also referred as severe, extreme or massive obesity) that is associated with the most complications.
Is diet effective in clinically severe obesity?
It is very difficult to follow a diet in the clinically severe obesity and almost always is ineffective. Although some kilos are lost in the beginning, the body very quickly “drops” its rhythms, because the brain sends a message to the body to store fat tissue even with minimal calorie intake. The patient is frustrated and usually he/she reactively eats much more.
In addition, all studies have shown that long-term weight loss is minimal in patients with clinically severe obesity who try to solve their problem only with diet and exercise
Why surgical treatment is necessary in clinically severe obesity?
Without exaggerating, there is no human system and organ that is not affected by obesity, especially in its extreme form.
Surgical treatment that is based on specific indications is the only way for the long-term effective treatment of clinically severe obesity. As effective treatment is considered not only the loss of the appropriate weight but also its maintenance at satisfactory levels over time, the improvement or the complete treatment of the diseases that accompany obesity as well as the improvement of the patient’s quality of life.
The patient’s decision to undergo surgery should be made consciously and after careful consideration. The surgical operation is not an easy solution: it should be accompanied by a radical change in the patient’s lifestyle (diet, exercise and psychology).
What are the indications for surgery in obesity?
The indications for surgical treatment of obesity are, according to the international guidelines, the following:
- Patients with a Body Mass Index (BMI) > 40
- Patients with a Body Mass Index (BMI) > 35 when there is at least one serious co-morbidity:
- Type II Diabetes Mellitus (or adult-onset or non-insulin-dependent diabetes
- High Blood Pressure (Arterial hypertension)
- Sleep apnea
- Obesity Hypoventilation Syndrome (OHS)
Patients are appropriate candidates for surgery, if:
- They report failed attempts to lose weight with diets and exercise
- They are adequately informed about the benefits and risks of the surgical operation
- They do not show severe psychopathology (e.g. schizophrenia)
- They do not suffer from active neoplastic disease
Obesity is characterized by conditions of chronic inflammation and a number of accompanying health problems, which makes obese patients susceptible to all kinds of infections. Find out more information about the relationship between obesity and serious illness from the new virus HERE
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