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Obesity is an excess proportion of total body fat. A person is considered obese when his or her weight is 20% or more above normal weight.
Body mass index or BMI: is the most common measure of obesity, It is defined as body weight in kg divided by the square height in meter of the person. A person is considered overweight if his or her BMI is between 25 and 29.9; a person is considered obese if his or her BMI is over 30.
Morbid obesity: means the excess of weight to the extent which can cause health hazards.
This is considered by a body mass index of 35kg/m2..
What Causes Obesity?
Obesity occurs when a person intake of calories exceeds the output.
However, there are also other factors that contribute to obesity:
- Age.
- Gender.
- Genetics.
- environmental factors
- Physical factors.
- Psychological factors.
- Medication.
- Other diseases as hypothyroidism.
Does obesity cause any complications?
Besides the psychological and social negative impact, obesity has a wide range of complications healthwise:
• Diabetes
patients with diabetes mellitus type 2 are overweight (BMI>25 and <30) and half of them are obese (BMI between 30 and 34)
The risk of developing Diabetes mellitus type 2 increases 5 times at BMI 25, 35 times greater at BMI 30, and 93 times greater at or above BMI 35. Given the morbidity and mortality that diabetes causes in young and middle-aged adults, this dis¬ease alone should elicit a call for action against the rising epidemic of obesity.
• Metabolic Syndrome
This includes a cluster of insulin resistance and hyperinsulinemia, dyslipidemia, essential hypertension, type 2 diabetes, increased risk of cardio¬vascular events. Polycystic ovary syndrome, which is characterized by ovulatory dysfunction, infertility, androgen excess, and reduced sex hormone binding globulin, nonalcoholic steatohepatitis; an increasingly common cause of abnormal liver function.
• Respiratory diseases
As a result of intermittent pharyngeal obstruction due to soft tissue enlargement and reduced tone in the muscles controlling the tongue and soft palate is the Obstructive Sleep Apnea (OSA), which is characterized by epi¬sodes of temporary suspension of breathing during sleep. Patients, with BMI that exceeds 40, have an incidence at least 10 times the norm of 2% to 4%.
Less common but more pathogenic than OSA is the obesity-hypoventilation syndrome, it leads through chronic hypoxia (inadequate oxygenation of the blood) and hypercapnia (A condition marked by an unusually high concentration of carbon dioxide in the blood as a result of hypoventilation) to pulmonary hypertension and right heart fail¬ure.
There is an increased preva¬lence and severity of asthma in obese children.
• Gastro esophageal reflux disease
There is a higher incidence of gastroesophageal reflux disease in obese patients. Objective measures of abnormal reflux by 24-hour pH monitoring and abnormal pressures at the lower esophageal sphincter on manometry support the clinical findings of increased prevalence.
• Cardiovascular Disease
Dyslipidemia is common in obese patient; it increases the incidence of atherosclerosis. The Car¬diac output, stroke volume, and total blood volume increase. This leads to increase in systemic vascular resistance and hyper¬tension.
The combination results in increased prevalence of myocardial infarction and stroke, two of the major causes of premature death in the obese.
• Incontinence
A large, heavy abdomen and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing, or laughing, especially by obese females.
• Menstrual irregularities
Morbidly obese women often experience disruptions of the menstrual cycle, including interruption of the menstrual cycle, abnormal menstrual flow, and increased pain associated with the menstrual cycle.
• Pregnancy
In obese women is associated with higher incidence of complication, this includes hy¬pertension, preeclampsia, late fetal death, gestational diabetes and higher risk of induction of labor and cesarean section. There is also evidence that the infants of obese patient are at higher risk of developing abnormalities.
• Osteoarthritis of weight-bearing joints
The additional weight placed on joints, particularly knees and hips, results in rapid wear and tear, along with pain caused by inflammation. Similarly, bones and muscles of the back are constantly strained, resulting in disk problems, pain and decreased mobility.
When to seek help?
You should be concerned if
- You have a BMI of 30 or higher, or
- You have an apple shape ; fat accumulates in abdominal region, or
- You have emotional or health issues.
What to expect when you come to our clinic
When you come to our center you will be welcomed by our friendly staff that will gladly take the time to explain our treatment options including surgical ones.
Management:
Non-surgical management
Weight loss programs, diets, and drug therapy have not shown long-term effectiveness in treating morbid obesity. Diet, exercise and behavior modification appear to reduce weight by reducing calorie intake and increase calorie consumption. These measures seem to be effective on the short term and less effective in morbidly obese.
Drug therapy causes many side effects on the cardiovascular system and only effective with diet and exercise for short period.
However results of all non-surgical therapy for weight loss in the morbidly obese remain poor.
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