The Disease of Our Time: Obesity and Its Treatment

 In our country, as in the rest of the world, the incidence of the chronic disease obesity is increasing. In general, obesity is the result of an imbalance between the energy supplied by food and the energy expended. It therefore seems to be a natural consequence of factors of modern life, such as a sedentary lifestyle, lack of physical activity and poor diet. Obesity is known to be closely linked to many diseases such as cardiovascular disease, type 2 diabetes and some types of cancer. Obese patients, adherence to a personalized diet supported by a regular exercise program was the most effective way to ensure weight loss and maintain ideal weight.Behavioral, pharmacological and surgical therapies are other important methods to combat this serious chronic disease, obesity. Obesity, the incidence of which has been increasing in recent years, is a public health problem for which many factors such as age, gender, education level, marital status, different eating habits, smoking and alcohol consumption and lack of physical activity are responsible. Obesity is generally defined as an excessive increase in the ratio of body fat mass to lean mass, resulting in an increase in body weight above the desired level according to height, while WHO defines obesity as abnormal or excessive fat accumulation in the body to the extent that it impairs health. The index called body mass index is used to determine obesity. this index is calculated by dividing the weight in kilograms by the square of the height in meters (BMI=kg/m2). According to this index, a BMI of 30.00 or above is defined as obese and 25.00-29.99 as overweight. Health expenditures related to obesity, which is considered a chronic disease, directly or indirectly affect national economies. Worldwide, expenditures for health problems caused by physical inactivity and unhealthy nutrition constitute 2-7% of health expenditures on average. It is reported that the obesity epidemic is one of the most important public health challenges in the world, its trend has reached an alarming level, especially for children and adults, and may lead to more health burden for future generations. For these reasons, it is important to investigate the factors that cause obesity, which is one of the biggest health problems of our age, and to know the treatment options well in order to determine the ideal treatment of obesity and its complications. Obesity, which is mainly the result of an imbalance between energy intake and expenditure, has a complex etiology caused by many factors such as genetic, metabolic, hormonal, hypothalamic, psychological, lack of physical activity and socio-economic level. Studies have shown that obesity is inevitable when the basal metabolic rate slows down with advancing age, the daily energy intake is not limited and physical activity is not increased, and that the incidence of obesity in women is higher than in men, especially at older ages. It is reported that the consumption of easily accessible, high in sugar and fat, high-calorie ready-to-eat foods with plenty of calories, fast and on-the-go eating habits, especially with industry, urbanization and a sedentary lifestyle that affect the change in lifestyle, cause excess calorie intake and when combined with inadequate calorie expenditure, overweight and then obesity are inevitable. There are various methods used in the treatment of obesity. The general condition and wishes of the patient decide which method to use. Changing living conditions plays a major role in the treatment of obesity. The body that attains a regular life with diet and exercise becomes healthier. It is possible to get away from bad eating habits with the help of a dietician. Individuals who include exercise and sports in their lives can have a more vigorous body. It is important for health to do the right exercises and movements with the guidance of a physiotherapist. People can stay away from wrong habits that cause weight gain with the support of a psychologist. In addition to these, it may be possible to find a solution to obesity with drug treatment. However, it is not a preferred method due to the high side effects of drugs. The aim of nutrition therapy in obesity is to reduce the Body Mass Index (BMI) value to the appropriate level. Weight loss can be achieved with regular nutrition and diets. Each individual has an ideal weight suitable for age, gender, activity status and genetic characteristics. Diet therapy specific to each person is different. For this reason, it is healthiest to follow a diet in line with the dietitian's recommendations. The daily amount of energy, protein and fat that the person should take is determined. After the nutrition program is made, it is necessary to follow this program under the control of a dietician. It is not right for people to follow various diet methods that they hear from their environment or the media. These diets are not personalized. It will not help obesity and may be harmful for body health. The body releases energy through exercise. Thanks to the right exercise programs specific to the person, weight loss is achieved in a healthy way. In addition, physical activity develops muscles and makes the person stronger, stronger, fitter and more energetic. Incorrect and heavy sports can do more harm than good to the body. Therefore, it is important to get expert support and be evaluated by a physiotherapist when making an exercise plan. Behavior modification therapy aims to avoid the reasons that lead people to eat. In negative situations, people who feel hungry and turn to food even though they are not actually hungry can be made aware that this behavior is not right. With social support, positive behaviors are reinforced and become a way of life. There are various drug therapies used in the treatment of obesity. However, these medications have many side effects. For this reason, medication should not be used unless it is necessary. If it is necessary to use medication, it is very important to do so under the supervision of a doctor. It is not right to use products sold for weight loss that are marketed in the environment or through the media. These products can lead to irreversible consequences for human health. The advanced treatment method used in the treatment of obesity is surgical treatment. This method can be used if other treatment methods do not work or are not thought to work. Surgical treatment methods are very diverse. All methods are applied with closed (laparoscopic) technique. New methods are emerging with the development of modern medicine. Surgeries applied in the surgical treatment of obesity should be performed by surgeons who are experts in their field.