Obesity, one of the most important health conditions that must be addressed in our time, can lead to many serious diseases if left untreated. A wide range of conditions—including cardiovascular diseases, diabetes, joint disorders, liver and biliary tract problems, obstructive sleep apnea syndrome, hypertension, stroke, and cancers such as uterine, breast, prostate, and colorectal cancer—may be associated with excess body fat, namely obesity.
What Are Obesity and Morbid Obesity?
The term “obesity” refers to excessive body weight, while “morbid” describes a condition that causes illness or disease. Morbid obesity, whose prevalence is rapidly increasing worldwide, is a severe form of obesity that results from excessive fat accumulation and is accompanied by diseases that may increase the risk of life-threatening outcomes.
What Are the Causes of Obesity?
Unhealthy dietary habits, excessive calorie intake, and a sedentary lifestyle are among the most important causes of obesity. However, the factors that trigger obesity are not fully understood. Familial predisposition and a wide range of neurological, physiological, environmental, biochemical, cultural, and psychological factors may contribute to the development of obesity.
What Health Problems Can Obesity Cause?
Obesity can lead to numerous health problems and risks by negatively affecting the endocrine, cardiovascular, respiratory, gastrointestinal, dermatologic, genitourinary, and musculoskeletal systems, as well as psychosocial well-being.
Morbid obesity in particular is associated with serious health conditions that can be life-threatening. These include hypertension, heart and kidney diseases, stroke, vascular occlusions, diabetes, sleep apnea, and other respiratory problems. Obesity may also contribute to conditions such as reflux, urinary incontinence, degenerative arthritis, and ulcers.
Studies indicate that obese men have a higher risk of developing esophageal, prostate, and colorectal cancers, while obese women have an increased risk of ovarian, breast, and uterine cancers.
How Is Obesity Diagnosed?
Obesity is generally diagnosed using Body Mass Index (BMI), based on the classification of the World Health Organization. BMI is calculated by dividing a person’s body weight in kilograms by the square of their height in meters (BMI = kg/m²).
In adults, a BMI above 30 kg/m² is classified as obesity, while a BMI above 25 kg/m² is considered overweight. In children, age- and sex-specific percentile curves are used: above the 90th percentile is defined as obesity, and above the 85th percentile is defined as overweight.
What Methods Are Used in the Treatment of Obesity?
The most important step in combating obesity is prevention—before the condition develops. Since obesity beginning in childhood often forms the basis for obesity in adulthood, preventive measures should start at an early age.
Obesity treatment is a long-term, continuous, and multidisciplinary process. Treatment should be managed by a team that may include a physician, dietitian, psychologist, and physiotherapist.
Treatment methods include medical nutrition therapy (diet), exercise therapy, behavior modification therapy, pharmacological treatment, and surgical treatment.
Who Is Eligible for Obesity Surgery?
Eligibility for obesity surgery is determined through a detailed evaluation of each patient’s individual characteristics. The choice of surgical method is made by considering factors such as BMI, presence of comorbidities, eating habits, and age.
According to international criteria, individuals with a BMI above 40 kg/m², or those with a BMI above 35 kg/m² accompanied by comorbidities such as hypertension, type 2 diabetes, dyslipidemia, or sleep apnea, may be candidates for obesity surgery.
Surgical Methods Used in the Treatment of Obesity
Sleeve Gastrectomy (Gastric Sleeve Surgery)
Sleeve gastrectomy is a surgical method in which a large portion of the stomach is removed to reduce stomach volume. Weight loss is achieved through the reduced stomach capacity and by removing the region that produces the hunger hormone ghrelin.
Gastric Bypass Surgery
Gastric bypass is one of the most commonly performed obesity surgery methods worldwide. A small gastric pouch is created and connected to the small intestine. This reduces the amount of food intake and supports weight loss through changes in absorption.
This procedure may also contribute to improved diabetes control through its effects on incretin hormones.
While methods such as the intragastric balloon and gastric banding are also used in bariatric surgery, they are less commonly preferred today due to their more limited indications.
What Are the Benefits of Obesity Surgery?
The ability to perform obesity surgery using laparoscopic and minimally invasive techniques reduces the risk of complications. With the weight loss achieved after surgery, many obesity-related comorbid conditions may improve significantly or even resolve completely.
Scientific studies show that laparoscopic sleeve gastrectomy and gastric bypass surgery are effective methods for weight loss and for controlling metabolic diseases in patients with morbid obesity.
