The definition of an obese person is a person who has excess fatty tissue and a BMI value of more than 30. BMI is an indicator that measures weight compared to height, as excess fatty tissue may have serious health consequences, such as: diabetes, and high blood pressure. High level of fats in the blood.
Obesity is one of the most common medical conditions in Western society today and one of the most difficult in terms of treating and combating. Relatively little progress has been made in treating obesity except for lifestyle changes, but much information has been collected regarding the medical consequences of obesity.
Obesity is diagnosed when your BMI is 30 or higher. To determine your BMI, divide your weight in kilograms by your height in square metres. The following table shows your BMI:
|low weight||less than 18.5|
|normal weight||18.5 – 24.9|
|Overweight||25 – 29.9|
|obese||30 and above|
For most people, BMI provides a reasonable estimate of body fat, however BMI does not directly measure body fat; So some people, such as: muscular athletes, may have a BMI in the obese category even though there is no excess body fat.
Reasons for treating obesity
Causes and risk factors for obesity
The main causes of obesity include the following:
Inactive people burn fewer calories than active people, as the National Health and Nutrition Examination Survey showed a strong relationship between physical inactivity and weight gain in both genders.
Overeating leads to weight gain, especially if the diet is high in fat.
Foods that are high in fat or sugar, such as fast food, fried foods, and sweets, have a high energy density, meaning many calories in a small amount of food.
A person is more likely to become obese if one or both parents are obese, as genetics also influences the hormones involved in regulating lipids.
One genetic cause of obesity is a lack of leptin, a hormone produced in fat cells and the placenta. Leptin controls weight by sending signals to the brain to eat less when body fat stores are too high.
If for some reason the body cannot produce enough leptin or the leptin cannot send a signal to the brain to eat less food, this control is lost and obesity occurs.
Follow a diet rich in simple carbohydrates
The role of carbohydrates in weight gain is unclear. Carbohydrates increase blood glucose levels, which in turn stimulate the pancreas’ secretion of insulin, which promotes the growth of fatty tissue and can cause weight gain.
Some scientists believe that simple carbohydrates, such as: sugars, fructose, sweets, and soft drinks contribute to weight gain. Because they are faster absorbed into the bloodstream than complex carbohydrates, such as: pasta, brown rice, grains, and vegetables.
The relationship between frequency of food intake and weight is somewhat controversial, there are many reports of overweight people eating less than people of normal weight.
Scientists have observed that people who eat small meals four or five times a day have lower cholesterol levels and lower and more stable blood sugar levels than people who eat less frequently, that is, two or three large meals a day.
One possible explanation is that frequent small meals produce stable insulin levels, while large meals cause a significant spike in insulin after meals.
Medications associated with weight gain include some antidepressants, anticonvulsants, some diabetes medications, some hormones such as oral contraceptives, and most corticosteroids such as prednisone.
Some high blood pressure medications and antihistamines cause weight gain. The cause of weight gain varies with medications for each medication. If this is a concern for you, you should discuss your medications with your doctor rather than stopping medication. Because this may have dangerous effects.
For some people, emotions affect eating habits, many people eat excessively in response to emotions, such as: boredom, sadness, stress, or anger, while most people who are overweight do not suffer from psychological disorders more than other people of normal weight.
About 30% of people who seek treatment for serious weight problems have difficulties with binge eating.
Obesity treatment with explanation
People who are obese and have a body mass index of more than 40 can undergo various gastric surgeries that lead to weight loss. The reduction in weight is estimated at about 50% of the patient’s initial weight.
Types of gastrectomy operations
Laparoscopic sleeve gastrectomy
Laparoscopic sleeve gastrectomy is one of the most prominent obesity operations, and it is a relatively new technique , as it appeared in 2003, and it is the result of the of scientific research, where seven negative hormones were discovered in the stomach that cause hunger, obesity and diabetes, hence the idea of cutting this part From the stomach to get rid of these hormones and also reduce the size of the stomach.
The gastric sleeve operation is performed by a surgical endoscope, which makes it safer and without risks or complications. The harmful part of the stomach that contains negative hormones that affects health and causes hunger, obesity and diabetes is cut. About 5/4 of the size of the stomach is cut, leaving only 1/5 of the stomach. The size of the stomach becomes small, and therefore the patient eats a small amount of food that makes him feel full for a long time and the patient loses his appetite for food.
The part that is cut from the stomach is the harmful part of the stomach, and by cutting it, human health improves and does not harm the health of the body at all, and here it should be noted that after a year of the operation, the size of the stomach grows a little, so the body gets enough food
Advantages of gastric sleeve
- It is performed laparoscopically, which makes it a safe and easy process, as it is carried out using surgical endoscopic devices that work to avoid complications or risks.
- The operation takes 45 minutes, and the patient recovers within a week, leaving the hospital one day after the operation and practicing his normal life within a week.
- It cures diabetes by 70% due to cutting the part of the stomach that contains harmful hormones that negatively affect the activity of the pancreas
- The patient’s appetite for food decreases and his appetite becomes very little
- The patient loses 50% of his excess weight during the first six months, and reaches his ideal weight within a year, after which the size of the stomach expands so that the amount of food becomes the same as the body’s needs
- It is the only process that maintains the physiology and performance of the digestive system, as there is no connection of the stomach to the small intestine or changing the course of food
- Sleeve gastrectomy works to lose weight and thus increase the chance of pregnancy for women, not the other way around, but it is preferable to become pregnant and have children one year after the operation.
- The patient took vitamins and iron for the first six months only as a precaution, after which it is stopped as the stomach size is slightly widened
Other types of gastric sleeve surgery
Reducing stomach size
*- Because the body needs specific amounts of food to carry out its main functions, and all that exceeds causes obesity, so the gastric sleeve operation depends mainly on that point where the stomach size is reduced by removing a part of it that is about 70-80% of its size Leaving a tube-shaped passage resembling a banana or a small portion resembling a small bowl, and this process cannot be undone again and the removed portion cannot be installed again.
In this way, the feeling of fullness will become very quickly, just eating food and filling the remaining small part of the stomach and you will not be able to eat a larger amount, and thus the amount of food you eat will decrease to the amount that your body will consume only without there being an excess that is stored, which will help you lose weight dramatically
Sleeve gastrectomy is classified under the category of surgical operations for the treatment of obesity and it differs and is decided according to the person, his health condition, weight, desire and goal.
In some other types, the upper part of the stomach is cut, then the small intestine is cut and attached to the top of the stomach, thus reducing the amount of food entering the stomach and absorbed into the body by entering undigested food into the small intestine immediately after eating it is not absorbed and excreted from the body, while the amount of food in the stomach and absorbed in the natural way decreases.
* – It is also possible in another type to tie the stomach by placing a strap around the upper part of the stomach to reduce its size, which limits the amount of food that it can absorb. It prevents you from eating more than you need
When food slowly enters your stomach, this will definitely make you feel full, which is what another technique relied on in which a hole is made in the middle of the stomach and then the stomach is closed around it and the stomach is tied vertically from the hole in the middle of its apex, while the doctor narrows the horizontal part near the esophagus and thus becomes the part From the stomach into which the esophagus enters the food is small and narrow and the food moves from it to the lower part in small quantities, you will inevitably reduce the size of your meals
Gastric sleeve surgery
Usually the operation takes several hours, depending on its type and health condition of the patient. In the beginning, the method of performing the operation is divided into two types, the first type is the natural one in which a surgical incision is made in the abdomen and then the stomach is sutured and the incision closed after that, which is not a preferred type for everyone, especially women because it leaves a large scar in the place that needs a cosmetic operation to treat it.
As for the other type, very small incisions are made in the abdomen and then a surgical endoscope is inserted through which the operation is carried out. After the operation, those incisions are closed as an ordinary small surgeon, which has its advantages over the previous type, first in terms of aesthetics and secondly in terms of speed of recovery from the operation.
The doctor uses general anesthesia in it, and the priority of any doctor at the beginning is to perform the operation with a medical endoscope, but in certain cases the doctor may have to resort to a surgical incision.
The doctor reaches the stomach, treats its tissues, cuts the part he wants to remove, and then closes the rest. Sometimes the doctor removes the gallbladder to avoid stones, and other times, the stones are treated through medications without removing the gallbladder.