About Obesity

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What is Obesity?

Obesity, in its simplest definition, can be defined as excess fat storage in the body.  It is a chronic, multifactorial disease with genetic and environmental causes. Excess fat accumulation in the body causes many diseases, impairs quality of life and shortens life expectancy. Obesity and obesity-related diseases are the second most common cause of death worldwide. Although there are many reasons; Decrease in physical activity, poor eating habits, hormonal diseases and genetic factors can be considered among the main causes of obesity.

There is an increase in the frequency of obesity all over the world. Between 1975 and 2019, a three-fold increase was observed in the number of obese individuals.  According to World Health Organization (WHO) 2016 data, 2 billion people worldwide are overweight and 650 million of them are obese. Proportionally, 39% of the adult population was found to be overweight and 13% was obese. Although the disease was previously considered only a disease of the adult population, its frequency is increasing in children and adolescents. It has been determined that there are 340 million obese individuals in the population between the ages of 5-19. The fact that obesity is seen in children and young people as well as adults is an indication that the number of obese individuals will increase in the coming years.  The obesity pandemic threatens the whole world. The desired success rates in the fight against this pandemic have not been achieved.

Various definitions have been made for the existence and grading of obesity. It is most often calculated using body mass index (BMI). Obesity is defined as proportionally excess fat accumulation in the body. However; Body mass index may not always accurately reflect obesity, that is, body fat percentage. Similarly, BMI may not give accurate results in childhood. For this reason, different definitions are used. Percentile values ​​in childhood, body fat ratios in adults, and waist-hip measurements are also used.

BMI is obtained by dividing the weight (kg) by the square of the height (m).

BMI :  (kg) / (m2)

World Health Organization (WHO) Obesity Classification According to Body Mass Index

CLASSIFICATION BMI (kg/m2)

Normal Range 18.5 – 24.9

Preobese – Overweight 25 – 29.9

Obese Class I 30 – 34.9

Obese Class II 35 – 39.9

Obese Class III > 40

Super obese > 50


Body Mass Index Calculation



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Other Obesity Classifications Apart from BMI

– 102cm for men; In women, a waist measurement greater than 88cm is considered the obesity limit and requires treatment.

– More than 25% in men; More than 35% body fat in women is considered the obesity limit and requires treatment.

– Class 2 is overweight in children over 120% of the 95th percentile; More than 140% of the 95th percentile is considered class 3 obesity.

Obesity-Related Diseases

  • Type 2 Diabetes
  • Hypertension
  • Obstructive sleep apnea
  • Hyperlipidemia and hypercholesterolemia
  • Non-alcoholic fatty liver disease
  • Depression
  • Degenerative joint disorders
  • Waist and back pains
  • Gastroesophageal reflux disease
  • Cholelithiasis (gallstones)
  • Asthma
  • Heart failure
  • Migraine
  • Pseudo tumor cerebri
  • Deep vein thrombosis and other vascular diseases
  • Venous stasis ulcers
  • Stress urinary incontinence (urinary incontinence)
  • infertility
  • Polycystic ovary syndrome
  • dysmenorrhea
  • sexual dysfunction
  • Increase in the frequency of many cancers,
  • Dermatitis

Who Should Have Surgery?

Diet and lifestyle changes should be recommended primarily to all patients. Surgical treatment should be considered in patients who are not successful with diet and lifestyle changes.

Bariatric & Metabolic surgeries are effective and reliable surgeries in the treatment of severe obesity and accompanying diseases. Compared to non-surgical treatment methods, mortality rates due to diseases accompanying obesity are reduced.

For patients with BMI>35kg/m2, with or without comorbidities
In patients whose BMI is 30-35kg/m2 and who cannot achieve permanent weight loss or improvement in concomitant diseases with non-surgical methods
Surgery should be considered in patients with BMI>30kg/m2 and type 2 diabetes.
In the Asian Population, the obesity limit should be considered as 25kg/m2 and surgery should be considered in patients with a BMI>27.5kg/m2.

In addition, it is required to fail the diet under medical supervision and be psychologically stable.

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Who Cannot Have Surgery?

  • Psychological instability,
  • Known and documented alcohol-substance addiction,
  • Eating disorders,
  • Serious medical illnesses that make anesthesia or surgery prohibitively risky. ASA (American Society of Anesthesiologist)
  • Those who are mentally deficient,
  • Unsupportive home environment.