What is Obesity?

Obesity can be expressed literally as excessive fat to the extent that it impairs health. It is the biggest public health problem of all developed and developing countries. The frequency of obesity and obesity-related health problems is increasing worldwide. Approximately one out of every 3 people in our country is obese.  Today, obesity is defined as a chronic disease.

Obesity todayin valorisedfor the Body Mass Index (BMI, body mass index, BMI) called height and weight arelationship is used.

Why Become Obese?

1-Lack of Physical Activity: A sedentary lifestyle reduces energy expenditure and accelerates age-related loss of lean mass and weight gain.

2-Food Preference: Increased access to cheap, accessible, high-energy food; foods rich in carbohydrates and fats with high glycaemic index, beverages with high sugar content, fast food consumption, increase in portion size can be counted as factors affecting the increase in obesity in the last 50 years.

3-Eating Disorders: Overeating, prolonged fasting time and uncontrolled eating in the following meal, night eating habits are the causes of obesity.

4-Insufficient sleep

5-Genetic predisposition

6-There are also some medical reasons that cause obesity. These should also be investigated by your doctor.

• Cushing's disease (high cortisol levels)
• Hypothyroidism (thyroid hormone deficiency)
• Polycystic Ovary Syndrome
• Growth hormone disorders
• Psychological factors (depression, seasonal affective disorders, etc.)
• Medicines

Obesity is not only an aesthetic problem

According to the World Health Organisation (WHO) data, obesity ranks 2nd after smoking among preventable causes of death.

The following list lists the diseases caused or contributed to by obesity.

• Cardiovascular Diseases: Myocardial ischaemia (heart attack), Hypertension (high blood pressure), Dyslipidaemia (high cholesterol level), Deep vein thrombosis (intravascular clot formation)

• Endocrine: Insulin Resistance, Impaired fasting glucose levels, Type 2 Diabetes (Diabetes)Polycystic ovary syndrome, Menstrual disorders (Menstrual irregularities), Infertility, Intrauterine death (Stillbirth)

• Neurological: Pseudotumour cerebri (idiopathic intracranial hypertension), Dementia, Stroke

• Psychosocial: Eating disorders, Self-esteem disorders, Body perception disorders, Depression, Social isolation

• Respiratory System: Exercise intolerance, Obstructive sleep apnoea, Asthma
• Gastrointestinal: Gastroesophageal reflux, Fatty liver disease, Cholelithiasis (Gall bladder stone formation)

• Dermatology: Strias (stretch marks), Cellulitis, Lymphoedema, Hirsutism (excessive hair growth)

• Urology and Nephrology: Kidney stones, Kidney failure, Urinary incontinence, Sexual dysfunction

• Increased incidence of cancer: Breast, Ovaries, Oesophagus, Stomach, Colon, Liver, Pancreas, Gallbladder, Endometrium, Prostate, Lymphoma

• Musculoskeletal System: Limitation of movement, Osteoarthritis (joint rheumatism), Back and lower back pain, Flat feet, joint problems, Forearm fractures

Obesity increases all-cause mortality. This rate is directly related to BMI; that is, the higher the BMI, the higher the risk of death.

How should an obese patient be evaluated?

It is recommended that BMI should be calculated during routine health checks of adults and waist circumference measurement should be added if BMI is 25-35 kg/m2.

Patients with BMI ≥ 25 kg/m2 or abdominal obesity should be evaluated for underlying causes and health risks. A detailed history should be taken and the patient's medical history including the time of weight gain, weight control experiences, diet and exercise habits, medications and smoking should be questioned.

After the physical examination, detailed blood tests, ultrasound, chest X-ray, lung X-ray, endoscopy tests should be requested and you should be examined by chest diseases, internal medicine, cardiology, psychiatry and anaesthesia doctors. If necessary, further investigations can be added to the anamnesis and examination.

Health risks associated with obesity should be identified. Although it does not increase cardiovascular risk, conditions such as symptomatic osteoarthritis, cholelithiasis, fatty liver, polycystic ovary syndrome and depression reduce quality of life; control of these health problems can be possible with weight control.