What is Obesity?
Obesity is defined by the World Health Organization (WHO) as an excessive accumulation of fat in the body to the extent that it impairs health. It is a chronic disease associated with morbidity and mortality, which occurs when there is an imbalance between energy intake and expenditure, often accompanied by a sedentary lifestyle. According to WHO, obesity has reached epidemic proportions worldwide, with over 1.9 billion overweight adults and 650 million obese individuals. In our country, according to Turkish Statistical Institute (TÜİK) data, the Body Mass Index (BMI) of individuals aged 15 and over increased from 32.4% in 2008 to 34.3% in 2016. Similarly, the obesity rate rose from 15.8% in 2008 to 19.6% in 2016. Consequently, healthcare services have become increasingly utilized to treat obesity and its associated conditions.
What Are the Causes of Obesity?
Obesity can develop from childhood. Unhealthy eating habits acquired during childhood form the foundation of dietary patterns in adulthood. Factors such as rapid technological advancements and lifestyle changes due to the COVID-19 pandemic contribute to obesity.
The main causes of obesity include:
- High-calorie diet
- Sedentary lifestyle
- Inadequate and poor-quality sleep
- Genetic factors
- Environmental factors
How is Obesity Diagnosed?
Clinically, obesity is determined using the BMI classification by WHO. BMI is calculated by dividing body weight (kg) by the square of height (m²). The classification is as follows:
- BMI below 18.5: Underweight
- BMI 18.5-24.99: Normal weight
- BMI 25.00-29.99: Overweight
- BMI 30-35: First-degree obesity
- BMI 35-40: Second-degree obesity
- BMI 40 and above: Morbid obesity
Since obesity is defined as excessive fat accumulation in the body, body fat percentage is also used as a diagnostic criterion. A fat percentage above 25% in women and 30% in men indicates obesity.
Obesity Brings Along Many Other Health Problems!
Obesity is a complex, multifactorial disease. It is often associated with cardiovascular diseases, obstructive sleep apnea, type 2 diabetes, hypertension, fatty liver disease, gastroesophageal reflux, polycystic ovary syndrome (PCOS), skin problems, low self-esteem, and various psychological issues. Preventing obesity-related chronic diseases and maintaining an ideal weight are crucial for overall health.
Obesity is a Treatable Disease
Various methods are used in obesity treatment. Realistic goals should be set based on the individual's obesity level, lifestyle, and age. The five main treatment approaches are:
- Diet Therapy: Diet is a primary method in obesity treatment. Individualized, need-based dietary programs yield successful results. Although crash diets may lead to rapid weight loss, they are neither sustainable nor healthy. There is no single ideal diet; the best diet is one that is personalized, sustainable, and applicable to the individual.
- Behavioral Therapy: This therapy aims to identify factors triggering excessive eating, control food intake, and regulate physical activity levels. It helps individuals lose weight and maintain a healthy lifestyle.
- Exercise Therapy: Exercise is an essential intervention to treat obesity and prevent obesity-related diseases. It should be tailored to the individual's age, health status, and physical abilities. When combined with diet, it produces more effective results.
- Pharmacological Therapy: When sufficient weight loss cannot be achieved through lifestyle changes, medication may be considered. However, only a limited number of FDA-approved medications are available. The FDA has warned against using over-the-counter or unverified weight loss drugs, as they pose significant health risks. Unfortunately, due to the influence of social media, many unregulated weight loss pills and teas on the market pose serious health threats and can even be fatal.
- Surgical Treatment: Bariatric surgery is an effective obesity treatment as it ensures long-term weight loss, reduces obesity-related comorbidities and mortality, and improves quality of life. It is classified into two main categories: malabsorptive (nutrient absorption-reducing) and restrictive (food intake-reducing) procedures. Some combined methods involve both approaches. For long-term success and reduced risks, pre- and post-operative dietary adherence is crucial.
Nutrition is Key in Obesity Treatment
Creating a personalized nutrition plan is essential in diet therapy. The primary goal is to help individuals adopt and sustain healthy eating habits. Therefore, the diet plan should be tailored, simple, easy to implement, and safe. Patient adherence to the diet is the cornerstone of success. To improve compliance, personal food preferences, education level, and social and personal factors should be considered. Obesity severity, health status, and previous weight loss attempts should also be evaluated when selecting a diet plan.
A well-planned diet should not lead to vitamin, mineral, or electrolyte deficiencies and should provide adequate energy for maintaining a healthy weight.
The main objectives of nutritional therapy are:
- Reducing body weight to the target level
- Meeting daily nutritional needs in a balanced manner
- Instilling correct eating habits in individuals
- Maintaining and controlling weight after reaching the target weight
Unsupervised Diet Programs Pose Health Risks!
Today, many people follow unsupervised diet programs to lose weight, which can be detrimental to health. These diets can slow metabolism, cause vitamin and mineral deficiencies, lead to gastrointestinal issues, and impair organ function. The goal of diet therapy is not merely rapid weight loss for aesthetic reasons but rather improving overall health.
It should always be remembered that healthy eating is the medicine of tomorrow, and the best investment you can make is in a healthy body.
Dietitian Edanur Koç
