Obesity

What is it?

Obesity is defined as pathological excessive body weight due to accumulation of adipose tissue. This condition, at the medical level, is further defined using an absolute parameter called Body Mass Index (BMI) that relates weight and height (kg/m2). A person with BMI higher than 30 is defined as obese. Obesity has three degrees: degree I – BMI between 30 and 35; degree II – between 35 and 40; degree III – between 40 and 45. Above BMI of 45, the patient is defined as super-obese. The origins of obesity are not simply related to a set of improper dietary behaviors: obesity is a disease with multifactorial etiology, which involves for the patient - if not properly treated - the onset of other serious diseases related to obesity, such as diabetes, hypertension, sleep apnea syndrome, gastro-oesophageal reflux disease and esophagitis, liver steatosis and in general the onset of metabolic syndrome. 

Which are the symptoms?

  • Excess weight
  • Hypertension
  • Diabetes
  • Gastro-oesophageal reflux
  • Sleep apnea
  • Walking difficulty
  • Discal hernias

How is it diagnosed?

The diagnosis of obesity can be made very simply by the patient himself: it is necessary to divide his weight expressed in kilograms by his height expressed in meters and then again divide the result by his height expressed in meters. BMI thus calculated is expressed in kg/m2. If the result is greater than 30, then the patient is obese. The immediate next step is a medical evaluation to better stratify the degree of obesity, related diseases, their severity, and to have a complete picture of the patient's metabolic situation.

How is it treated?

The treatment of morbid obesity is surgical after failure of previous dietary-behavioral attempts. The obese patient who has tried diets in the past but still finds himself in the condition of obesity must seriously think about consulting a surgeon for definitive treatment that will lead to recovery from obesity and from the dreaded consequences that untreated obesity will surely cause the patient (e.g. hypertension, diabetes, myocardial infarction, stroke, severe sleep apnea syndrome, esophagitis up to Barrett's esophagus, hepatic steatosis, hypercholesterolemia, cardiovascular pathologies). Surgical treatments for obesity include restrictive-metabolic surgeries (such as sleeve gastrectomy or sleeve gastrectomy with associated antireflux plastic); malabsorptive surgeries (such as gastric By-Pass or gastric mini-by-pass); and reversible restrictive-metabolic surgeries (reversible sleeve gastrectomy, bariclip). All surgeries are performed using a minimally invasive laparoscopic technique through 4 small incisions that allow the surgeon to work and perform the procedure. The benefits of the laparoscopic technique allow an earlier return to normal patient activities with a lower impact of hospitalization and less postoperative pain.

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