WHAT IS MORBID OBESITY?
Morbid obesity is a term we start to hear frequently in our daily lives. It literally means “obesity in the degree of illness”. It is a health problem that causes serious health problems and affects socioeconomically and psychologically in terms of health.
A measure commonly used today to describe morbid obesity is the body mass index (BMI), which is the ratio of the person's weight in kilograms to the square of height in meters (kg / m2). Patients with a BMI of 40 or more are defined as morbid obese, except for those who are engaged in bodybuilding sports or patients who accumulate fluid in their abdomen due to diseases such as cirrhosis.
Diseases and clinical disorders caused by morbid obesity increased cholesterol level in the blood, atherosclerosis, high blood pressure, cardiovascular diseases, heart failure, diabetes mellitus, obstrctive sleep apnea, blood clot in the veins and their occlusion of the lung arteries, fatty liver, cirrhosis , gallstones, menstrual irregularities and infertility in women, increased risk of cancer, especially breast, cervical, ovarian, prostate and colon cancer, etc.
Although individuals who want to be treated for morbid obesity generally have criticisms such as “you are beautiful like this”, “what you need to lose weight” or “just surgery for beauty”, these individuals actually want to be treated to get rid of the negative effects of morbid obesity in their lives. Physicians, on the other hand, recommend the treatment in order to save the patients from these social problems and to protect them from the diseases listed above, which they may encounter in the 10-20 year period before them even if they have not encountered them now.
In the treatment of obesity, it is necessary to regulate eating and drinking habits and exercise regularly. Drug treatment is possible for patients who cannot lose weight with these methods, although there are a limited number of alternatives. However, most of the individuals who lose weight after adjusting their eating and drinking habits, which we define as diet in general, are bored with diets and quickly regain their weight because they cannot adopt the concept of “changing lifestyle”. Surgical treatment, which has become very popular in our country in recent years, is another alternative, and these surgeries are called Bariatric Surgery.
At the Obesity Consensus Conference organized by the American National Institute of Health in 1991, it was decided that surgical treatment is the most effective and reliable way to treat morbid obesity and associated comorbidities. As a result of this conference, bariatric surgery was recommended for patients whose BMI was greater than 40 kg / m2 or BMI was between 35 and 40 kg / m2 and had adverse problems related to obesity. The International Federation of Obesity and Metabolic Diseases Surgery pulled these criteria down five points in August 2016. Recently, criteria was pulled down 5 points again by IFSO and ASMBS in 2022. It means that anybody who has 35 kg/m2 or more BMI has an indication for bariatric surgery now.