Obesity is recognized as one of the most significant and widespread health issues of the 21st century. Rapid urbanization and nutritional problems worldwide are increasing the risk of obesity. With an obesity prevalence of 32%, Turkey ranks first among adults in Europe. As in the rest of the world, we observed an increase in weight gain and obesity problems in Turkey during the pandemic. We all went through a difficult period. People were confined to their homes, and physical activity decreased. Naturally, everyone experienced some weight gain.
Obesity was already a major problem, and now it has become even more serious. During the pandemic, people gained an average of 6 kilograms per person. Individuals with obesity are at a higher risk of contracting COVID-19 and experiencing more severe illness compared to those with normal weight. Among those infected with COVID-19, 46% are obese. The risk of hospitalization for these individuals is approximately twice as high as for those without weight issues. Studies have shown that among patients under the age of 50 with obesity, hospitalization, in-hospital death, and the need for mechanical ventilation due to COVID-19 are significantly higher. Additionally, obesity leads to numerous serious health problems such as diabetes, hypertension, high blood pressure, elevated blood lipids, coronary artery disease, stroke, various cancers, sleep apnea syndrome, fatty liver disease, acid reflux, gallbladder disease, infertility, depression, joint and mobility issues.
In Turkey, 41% of women and 20.5% of men are either obese or overweight. Individuals with obesity are at high risk for COVID-19 infection and virus-related mortality. Among hospitalized COVID-19 patients, individuals with obesity rank second after those with hypertension.
In the UK, approximately 7 out of 10 patients admitted to intensive care due to coronavirus were obese. A study conducted on more than 5,000 COVID-19 patients in the United States found that severe obesity was the second most significant risk factor for hospitalization after age, with 41.7% of the patients being obese.
Obesity has a direct negative impact on the immune system. The immune system is suppressed in obesity, increasing susceptibility to infections. Respiratory function impairment in individuals with obesity may contribute to the increased risk of severe COVID-19. Due to excess fat accumulation in the airways, individuals with obesity have higher airway resistance and smaller lung volumes. Additionally, their respiratory muscles are weaker. As a result, they experience hypoventilation syndrome, making deep breathing more difficult.
You Are Not Alone in Fighting Obesity
There are many treatment options for obesity. Surgical treatments and endoscopic procedures are among the most commonly used methods. To determine the severity of obesity and a patient’s weight status, we use the body mass index (BMI) criteria to decide on surgical or endoscopic intervention. According to these values, a BMI of 20-25 is considered normal, 25-30 is overweight, 30-35 is obese, and 35 or above is classified as morbid obesity.
We recommend surgical treatment for patients with a BMI over 35 who have an obesity-related comorbidity or those with a BMI over 40, even without any comorbidities. For overweight patients with a BMI below these thresholds, we use non-surgical, endoscopic treatment methods.
Obesity Causes 70 Different Diseases
The circulatory, digestive, excretory systems, and other bodily functions are all negatively affected by obesity. Obesity also increases the risk of cancer. Moreover, studies have shown that among morbidly obese pregnant women, complications for both the mother and baby are significantly higher compared to women who lost weight after obesity surgery before pregnancy. Preventing and treating obesity is the first step in combating all these diseases.
Surgical treatment significantly reduces the diseases caused by obesity. When considering all types of obesity surgery, their overall success rates are similar. After surgery, approximately 70% of patients completely recover from hypertension and diabetes. A significant number of patients who previously required insulin injections transition to oral medications. Gastric sleeve surgery prevents diabetes and hypertension in 90% of cases.
Heart diseases also decrease as blood sugar, blood pressure, and cholesterol levels drop. Kidney diseases significantly decline with the resolution of diabetes. Patients with sleep apnea syndrome often completely overcome their condition after surgery.
After medical examinations and tests, suitable patients may undergo surgery. Obesity surgery is not performed in cases where obesity is caused by thyroid dysfunction, corticosteroid use, or endocrine organ diseases; if there is an addiction to drugs, alcohol, or other stimulants; if there is a serious psychiatric condition; or if pregnancy is planned within one year. When evaluating all diseases, the success rate of surgery exceeds 80%. In today's conditions, surgical treatment is the most effective and successful option available.
Take Back Control of Your Life
Insulin resistance, which emerges during periods of excessive weight gain, increases the risk of developing diabetes. There is strong evidence that weight loss prevents and delays the onset of diabetes. Studies show that weight loss reduces the risk of hyperglycemia (high blood sugar) by 23 times and the risk of hyperinsulinemia (excess insulin) by 6 times. Losing weight improves insulin sensitivity, helping to reverse insulin resistance. Even a 5% weight loss enhances insulin function and lowers fasting blood glucose levels.
The key is to make healthy eating and physical activity a way of life. Being overweight and obese are often perceived as a personal failure, but obesity is not a fault—it is a disease! Moreover, it is a complex condition that cannot simply be reduced to "eating too much" or "moving too little." Many factors contribute to weight gain, including a person’s psychology, genetics, stress levels, metabolism, and hormonal balance.
Op. Dr. Yunus Öztürk
General Surgery Specialist
