1-What is morbid obesity?
2-Prognosis
3-Symptoms of morbid obesity
4-Medical tests
5-Causes of morbid obesity
6-Can it be prevented?
7-Treatments
8. Which specialist treats it?
What is morbid obesity?
Morbid obesity, extreme obesity or class III obesity is a chronic disease that appears when there is an excess of adipose tissue -that is, fat- in the body.
It is the most prevalent chronic metabolic disease in developed countries and is associated with a large number of diseases such as hypertension and diabetes.
This disease is characterized by a progressive increase in body mass until it reaches a point where this increase poses a risk to the patient’s health, and today it is one of the most important public health problems in the world.
To measure this, the Body Mass Index (BMI) is used, which is calculated by dividing weight (in kilograms) by height (meters squared).
BMI Table
BMI gives an approximate estimate of body fat, although it does not measure it directly. Cases of very muscular people may have a BMI corresponding to obesity without actually having excess fat. A person is considered obese when his or her Body Mass Index is between 255 and 29.9 or more than 45.5 kilos above the weight recommended by the physician.
Prognosis of morbid obesity
Morbid obesity is a disease associated with a large number of comorbidities. That is to say, an obese person can also develop multiple pathologies more or less risky for health. Some of them are:
- Diabetes
- High blood pressure
- Heart problems
- Problems or risk of suffering a cerebrovascular accident.
- High cholesterol
- Metabolic syndrome
- Breathing disorders such as sleep apnea
- Gallbladder problems or disease
- Cancer in multiple variables: cervical, endometrial, ovarian, breast, colon, rectal, gallbladder, liver, kidney, pancreatic and prostate cancer.
- Erectile dysfunction
- Arthrosis
- Non-alcoholic fatty liver disease
Sedentary lifestyle and unhealthy
unhealthy diet are the main causes
Symptoms of morbid obesity
When a person begins to accumulate fat progressively in his body he starts to put on weight, and this fat can accumulate in different places of the body.
One of them may be in the lower diaphragm or chest wall, and this fat can exert some pressure on the lungs and cause a feeling of difficulty breathing and a feeling of suffocation, even when making minimal efforts such as walking or climbing stairs.
Breathing can seriously interfere with sleep with the so-called sleep apnea. In this case, there is a momentary cessation of breathing, a fact that causes certain complications.
Bone and joint problems are also frequent, with problems of osteoarthritis in the legs or pain in certain areas, such as the lower back.
Medical tests for morbid obesity
When diagnosing obesity, the specialist must perform a series of tests or examinations to make the diagnosis.
– The patient’s medical history should be elaborated.
– The specialist will perform a general physical examination
– BMI is calculated
– Waist circumference is measured
– Blood tests
What are the causes of morbid obesity?
The intake of high-calorie products, associated with a sedentary and unhealthy lifestyle is usually the main culprit for the change in a person’s weight. However, there are numerous problems or reasons why the person may end up suffering from the disease.
- Genetic factors: Genetic inheritance can affect the amount of body fat that is stored.
- Environmental factors: the person’s environment can be a key factor in the development or not of this disease. Thus, the type of food, the amount of physical exercise that the person and his or her environment perform or the lifestyle habits of these people who are part of the environment have an influence. It is common for obesity to appear in all members of a family, since not only genetics but also eating and activity habits are shared.
- Psychological factors: various states such as stress, anxiety or depression can incite the person to eat compulsively.
- Thyroid disorders: some thyroid problems can lead to obesity.
In turn, there are a number of risk factors that can contribute to obesity:
- The person is inactive and does not burn calories.
- Medical problems: some disorders can cause obesity. Some diseases such as arthritis decrease the level of physical activity and cause weight gain.
- Age: As you get older, the risk of obesity increases.
- Medications: there are certain medications that can cause weight gain, such as antidepressants, anticonvulsants, diabetes drugs, steroids…
- Pregnancy: during the gestation period women gain weight irremediably, although after childbirth it is not easy to lose it, so it can have an influence on obesity.
- Quitting smoking: it is common to associate quitting smoking with weight gain.
- Lack of sleep: not enough sleep or too much sleep can cause hormonal changes that increase appetite.
Can morbid obesity be prevented?
Individuals can try to take steps to avoid excessive weight gain to prevent comorbidities related to weight gain. Measures to avoid weight gain have to do with leading a healthy lifestyle, exercising and controlling what is ingested on a daily basis.
- Regular exercise: three to six hours a day of moderate exercise to prevent weight gain. Walking, jogging or swimming are highly recommended.
- Eating a healthy and balanced diet: eating foods rich in nutrients and low in calories is vital. Cereals, fruits and vegetables are the most recommended. Avoiding saturated fats and reducing the consumption of alcohol and sweets is important, although you can eat something from time to time. Eating three meals a day with few snacks is ideal.
- Identify and avoid situations out of control.
- Be consistent.
Treatments for morbid obesity
Reducing the weight of the morbidly obese patient produces an improvement in all associated comorbidities, as well as an improvement in both quality of life and life expectancy.
To lose weight, there are specific diets combined with exercise that can help to reduce an important part of the excess weight. In cases where neither diet nor exercise are shown to be effective treatments, the option of surgical intervention is considered.
The surgical option to put an end to morbid obesity is the so-called obesity surgery, of which there are several techniques. However, these are performed laparoscopically, in a minimally invasive way with small incisions that allow a simple postoperative period and a quick recovery.
There are two types of obesity surgery. On the one hand, restrictive surgery, such as the gastric sleeve or tubulation, in which the stomach is made smaller. On the other hand, the best known option is malabsorptive surgery, which includes, among others, gastric bypass.
Obesity surgery treatment options:
- Intragastric balloon: it is installed by endoscopy and between ten and fifteen kilos are lost with its use. However, it is a moderate weight loss compared to other treatments. It is sometimes used as a preoperative for other treatments.
- Gastric bypass: this is the most commonly used treatment and 60-70% of excess weight is lost over a period of three years. It combines restrictive and malabsorptive action.
- Gastric tubular: this is a relatively new procedure which consists of almost total removal of the stomach over an orogastric tube. The tube limits the volume ingested and is the technique of choice for many patients. The rate of weight loss is similar to that of bypass.
Which specialist treats morbid obesity?
The specialist in charge of treating morbid obesity is the General Surgeon, who will be in charge of performing the surgical intervention.
However, morbid obesity should be treated from a multidisciplinary point of view that includes specialists in Endocrinology or Nutrition, which are important when determining diets and ways to lose weight.