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OBESITY


This is a state of an excessive amount of body fat accumulation and storage. Obesity is a metabolic syndrome that must be treated. Obesity is not a simple over-weight problem that can be treated with traditional methods; rather, this is a serious clinic disease and social dangerous health problem with high health risks because obesity is an important risk factor for many diseases. 

Body weight remains stable for most of the people because energy intake and consumption due to energy homeostasis meet one another for a long time. In response to changes in fat volume, brain triggers compensatory adaptation resisting to changes in the body weight resistance. For instance, while weight loss increases hunger and suppresses metabolic rate, gaining weight creates contrary responses. This homeostatic system protects the body against weight loss rather than gaining weight. Understanding this system today is leading to the development of anti-obesity agents.

Criteria used in the diagnosis of obesity are more geared toward determination of body weight that creates many diseases. Body Mass Index (BMI) and waist circumference measurement is usually sufficient for the diagnosis of obesity. Furthermore, different tests may be applied in evaluation of obesity.  

Body Mass Index
Body mass index is the most widely accepted parameter for evaluation of the body fat excess. Body mass index is used due to its easy applicability in clinic studies and epidemiological (social) studies for evaluation of effectiveness and risk of a person. 

It is formulation as: Body Mass Index=Body weight (kg)/ height (m)2.

Body Mass Index is not a definitive diagnosis alone; thus, risk rates can be determined by examining various anthropometric measures such as age, gender, muscle mass, ethnic origin and body structure of a person in a clinic environment. 

According to the classification determined by World Health Organization;

Body Mass Index below 18.5 Underweight
18.5 - 24.9 Normal Weight 
25.0 - 29.9 Overweight 
30.0 - 39.9 Obese 
Above 40.0 Morbidly (severe)
obese.

Risk Factors in Obesity
Heredity or genetic predisposition, hormonal and metabolic factors, psychological problems, excessive and wrong eating habits, lack of physical activity, age, gender, level of education, socio-cultural factors, income status, application of very low-energy diet at frequent intervals, smoking-alcohol use and the number of births are the major risk factors in pathogenesis of obesity.   

Obesity is one of the major health problems of our time. Incidence of obesity in our country is increasing day by day as throughout the world. A significant increase is seen in childhood obesity as an increase in obesity in adults. The reason of increase in prevalence of obesity especially in children is change of nutrition habits in modern life and decrease in physical activity depending on life style facilitated together with increasing technology. Excessive fatty nutrition diet with rich in refined sugar and carbon hydrate and poor in vegetable fiber with fast food and unhealthy food are one of the important factors leading to obesity in our time. 

Obesity Treatment
Being risk factor in the formation of many diseases, obesity can be prevented with an active life style and correct and healthy eating habits. Obesity can be prevented with regular control and correct treatment and longer and more quality life style can be achieved.   

Most of the obese people want to lose weight quickly and easily but it is not easy to accomplish this. Losing weight and maintaining your weight depend on long-term behavior change and healthy and balanced nutrition and increasing your physical activity. Main point in treatment in regard to this purpose is to reduce energy intake and to increase energy consumption. Clinicians, medical nutritionists, exercise physiologist, a psychiatrist and bariatric surgery surgeon should cooperate for the most appropriate treatment of obese and overweight persons. Even a decrease by 10 % in the body weight provides a very significant reduction in risk factors in relation to obesity. For this reason, up-to-date treatment recommendations have been focused on 10 % weight loss and in the meantime, purpose is to ensure perpetuation of weight loss for a long time. Patients having focused in obesity treatment generally strive to attain unrealistic weights in a very short time. In case of failure to achieve this, treatment is quitted or recurrences are frequent. Indeed, according to the statistical data, more than 95% of the people whom obesity treatment is applied regain weight. In this sense, losing weight in a healthy way as well as perpetuation of weight lost are very important milestones of treatment. Therefore, realistic objectives should be set even at the beginning of the treatment. As a realistic target, loss of 5-10 % in 6 months should be aimed. A wide range of treatment methods such as diet (healthy nutrition) treatment, physical activity (exercise), behaviour treatment, drug treatment, combined treatment and surgery are implemented in obesity treatment.