Obesity. The word suggests bulging waistlines and growing numbers on a scale. People often use such a number or the stretching of once-loose clothing as a trigger for seeking treatment for obesity, but according to George Kerlakian, MD, a bariatric surgeon with TriHealth Weight Management, obesity can contribute to several health risks and should be treated before it affects more than just a waistline.
It’s important to define the risks of obesity. The World Health Organization, along with other national and international medical organizations, recognizes obesity as a chronic, progressive disease that results from multiple genetic and environmental factors. It can lead to increase in conditions and symptoms like migraines, non-alcoholic fatty liver disease, polycystic ovarian syndrome in women, venous stasis disease, gout, degenerative joint disease, GERD, hypertension, cardiovascular disease, asthma, obstructive sleep apnea, depression, diabetes, and certain forms of cancers, among others.
“People affected by obesity or severe obesity are about 10 times more likely to have Type 2 diabetes, which can nearly double the risk of death. It’s also associated with amputations, heart disease, stroke, blindness, kidney disease, and decreased healing,” said Dr. Kerlakian.
Obesity happens over time when the body experiences a decreased metabolic rate over a prolonged period. The basal metabolic rate, or BMR, is the amount of energy required by the body to conduct its basic functions over a certain time. Factors that increase the metabolic rate include lean body mass, physical activity, growth and development, being male, height (overall size), stress, and digestion.
Factors that decrease the metabolic rate include aging, fat mass, starvation and dieting, sedentary living, being female, and sleep. An increased or a decreased metabolic rate can lead to a deviation from the metabolic set point, which is the weight range in which your body is programmed to function optimally.
According to Dr. Kerlakian, there are a few different ways to combat obesity.
One of these ways involves lifestyle modifications. These include a combination of a reduction in caloric intake, improved food choices (lean protein, high fiber, “good” carbohydrates), increased physical activity, and behavior modifications, such resisting the urge to eat out of boredom.
Medical weight loss and metabolic bariatric surgery are other options. Medical weight loss, or medical weight management, can include behavior modifications like diet and exercise, as well as pre-packaged meal replacement plans, and weight loss medications.
Metabolic bariatric surgery includes primarily roux-en-y gastric bypass surgery, and gastric sleeve surgery. Gastric bypass is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting it directly to the small intestine. After the surgery, swallowed food will go into this small pouch of stomach and then directly into the small intestine, bypassing most of the stomach and the first section of the small intestine.
Gastric sleeve surgery is a laparoscopic procedure that involves making several small incisions in the abdomen and performing the procedure using a video camera and long instruments placed through the incisions. During the procedure, about 90 percent of the stomach is removed, leaving a narrow gastric tube, or “sleeve.” No intestines are removed or bypassed. However, long-term follow-up after this surgery is very important, as is lifelong replacement of vitamins and minerals to prevent complications.
“If you have been struggling with your weight and are concerned about your own health risks, talking to a healthcare provider can be a vital first step,” said Dr. Kerlakian. “Every patient is different, so at TriHealth Weight Management, we work with each individual to determine which course of weight loss treatment is best for them.”