Obesity or fatness is one of the major health problems in developed and developing countries today. Obesity is an increase in body weight above the desired height due to an excessive increase in body fat relative to overall lean mass.
As we all know , nutrition is a necessity of life that begins in the womb and continues until the end of life. However, nutrition should be healthy. Healthy nutrition is the ability of a person to take in the nutrients necessary for growth, development and life in sufficient and balanced amounts and for a sufficient time and to use them in the body. Healthy nutrition is not about filling your stomach, suppressing hunger, or eating and drinking whatever you want.
What is Obesity?
In daily life, individuals (pregnancy, breastfeeding, infants, young children, elderly, workers, athletes, cardiovascular, diabetes, high blood pressure, respiratory disorders, etc.) need daily energy that varies according to their age, gender, profession, genetic and physiological characteristics and disease status.
In order to live a healthy life, energy consumption and energy consumption should be kept in balance.
Fat tissue makes up 18% of body weight in adult men and 25% in women. When this ratio is greater than 25% in men and 30% in women, it is called obesity. Obesity is also a common health problem in children .
If the daily energy intake is more than the energy spent, the unconsumed energy is stored as body fat, causing obesity.
At the same time, today's development of technology has made life easier, but has significantly limited daily movements.
As can be understood from obesity; the energy absorbed from food (calories) being more than the energy consumed and the excess energy being stored as fat (or more) in the body is considered a disease that negatively affects quality and durability.
Obesity is defined by the World Health Organization (WHO) as the accumulation of too much fat in the body that is harmful to health. People with excessive fat accumulation in their bodies are obese .
What are the causes of obesity?
Although the factors that cause obesity cannot be fully explained, excessive and improper nutrition and lack of physical activity are considered the most important causes of obesity. In addition to these factors, there are many interrelated genetic, environmental, neurological, physiological, biochemical, sociocultural and psychological factors that cause obesity. Considering that the increase in childhood obesity is too high to be explained by factors alone, it is accepted that environmental factors play a major role in the development of obesity.
The main risk factors for obesity are;
Excessive and incorrect nutrition
Insufficient physical activity
Age
Gender
Level of education
Cultural factors Socialization
Income level
Endocrine and metabolic factors
Genetic factors
Psychological problems
Regular intervals Very low energy diet
Smoking and alcohol
Certain medications are consumed (antidepressants, etc.)
Number of births and interval between births
One of the factors that should be considered in the development of obesity is nutrition in the first years of life. It is reported that obesity rates are lower in children who are breastfed than in children who are not breastfed, and the duration, type, amount and timing of complementary feeding are effective on breastfeeding success.
Various documents published by WHO and UNICEF (United Nations Children's Fund) state that feeding babies only with breast milk for 6 months, continuing breastfeeding after 6 months, starting complementary food in sufficient quantity and quality, and continuing breastfeeding for at least 2 years can reduce the risk of obesity and chronic diseases in the short term and in the long term.
What are the Health Problems Caused by Obesity?
Obesity causes many health problems due to its negative effects on body systems (endocrine system, cardiovascular system, respiratory system, digestive system, skin, genitourinary system, musculoskeletal system) and psychosocial status.
The relationship between obesity and various diseases is well known and its effect on increased morbidity and mortality has also been demonstrated.
Being overweight is responsible for more than 1 million deaths and 12 million annual morbidities in the European Region each year.
What diseases does obesity cause?
Insulin resistance – Hyperinsulinemia
Type 2 diabetes (diabetes mellitus)
Hypertension (high blood pressure)
Coronary artery disease
Hyperlipidemia – Hypertriglyceridemia (increased fat in the blood)
Metabolic syndrome
Gallbladder disease
Certain types of cancer (gallbladder, endometrial, ovarian and breast cancers in women, colon and prostate cancer in men)
Osteoarthritis
Sleep apnea
Fatty liver
Asthma
Shortness of breath
Complications of pregnancy
Irregular menstruation
Hair growth
Increased risk of surgery
Psychiatric problems (anorexia nervosa (not eating) or schizophrenia (not taking in food due to vomiting), bulimia, night eating syndrome) or trying to achieve psychological satisfaction by eating more
Social illness - adjustment
Skin infections, fungal infections of the groin and feet, especially decreased and increased c regular grace due to excess subcutaneous fat
Musculoskeletal problems
How is Obesity Treated?
Obesity prevention is extremely important. Obesity prevention should start in childhood. Obesity in children and adolescents paves the way for obesity in adulthood. Therefore, families, schools and the environment should be informed about adequate and balanced nutrition and physical activity. Obesity treatment is a long and ongoing process that requires individual determination and active participation. The fact that many factors are effective in the etiology of obesity makes the prevention and treatment of this disease extremely difficult and complex. Therefore, a team consisting of a doctor, nutritionist, psychologist and physiotherapist is needed in obesity treatment.
The aim of obesity treatment is to reduce the risk of obesity-related morbidity and mortality by targeting realistic body weight loss, to provide the individual with adequate and balanced eating habits and to increase the quality of life. Losing body weight over a period of 6 months provides significant benefits in preventing health problems caused by obesity.
The methods used in obesity treatment are grouped into 5. These methods are;
1. Treatment of obesity with medical nutrition (diet)
Medical nutrition therapy plays an important role in the treatment of obesity. With nutrition therapy in obesity:
Body weight should be reduced to the extent that it should be according to height (BMI = 18.5 – 2.9
kg/m2). It should not be forgotten that medical nutrition treatment (diet) is specific to each individual. The targets determined at the beginning may be the person's ideal weight or slightly above the ideal weight.
The applied weight loss diet should be in accordance with the principles of adequate and balanced nutrition. The aim is to help the individual gain and maintain correct eating habits.
When body weight reaches a level comparable to height (BMI = 18.5 –
2.9 kg/m2), weight gain should be avoided and weight loss should be continued.
2. Exercise therapy
Although the effects of exercise therapy on weight loss are controversial, it is definitely accepted that physical activity reduces fat and regional fat tissue and prevents the loss of muscle mass that can be seen with diet. In people who support medical nutrition therapy with exercise therapy, weight gain can be prevented while weight loss and regain can also be prevented.
Adults should do 30 minutes of moderate-intensity exercise per day. This level of activity
provides 80 kJ (200 kcal) of energy expenditure per day. Obese people should aim to be physically active every day. Energy expenditure levels vary depending on each person's body weight and the intensity of the activity.
The basic principles of exercise therapy are:
Exercise type; Walking, increasing daily activities, resistance training
Exercise frequency;
Exercise per day or at least 5 days/week Duration;
060 minutes/once per day, 2030 minutes/twice per day
Exercise intensity; P70 Maximum oxygen uptake
The most important issue when implementing an exercise program in obese individuals is to keep the risk of injury as low as possible while increasing energy expenditure. The recommended exercise program should be personalized, enjoyable, applicable, and suitable for the individual's daily lifestyle.
3. Treatment of obesity with behavioral changes
Behavior modification therapy in terms of body weight control is a form of treatment that aims to positively change or reduce negative behaviors related to diet and physical activity, leading to excessive weight gain, reinforcing positive behaviors and demonstrating positive behaviors. is a lifestyle. Stages of behavior modification therapy:
Self-observation
Controlling stimuli
Developing alternative behaviors
Reinforcement, self-reward
Cognitive restructuring
Social support
4. Pharmacology (drug) treatment
The drugs used in the treatment of obesity are not suitable for people with mild to moderate overweight. It is very important that the reliability of the drugs used is determined, that they affect the cause of obesity, that they do not have significant side effects in the short and long term, that they are not addictive, and that these drugs do not cause addiction. They should be used under the advice and supervision of a doctor.
In order for obesity treatment to be successful, the patient must continue medical nutrition and exercise therapy in addition to drug therapy and have regular physical examinations.
5. Surgical treatment
The surgical approach to obesity is basically divided into two. The purpose of weight loss surgery to reduce energy intake with food is to reduce the absorption of nutrients in the gastrointestinal system. For this purpose, bypass surgery, gastric dilatation, gastric dilatation, balloon angioplasty, etc. methods are used. The purpose of reconstructive surgery: to remove existing fat tissue in different parts of the body. This treatment method is predominantly cosmetic and if the patient cannot meet the necessary conditions for obesity treatment, fat accumulation occurs again.
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