In the medical field, obesity or significant overweight is identified as a recurring factor. This implies that the struggle with weight could be lifelong. Obesity is generally characterized by an excessive body weight due to the accumulation of surplus fatty tissue. A person is diagnosed with the disease if their body mass index (BMI) exceeds 30.

According to bariatric surgeon Donatas Danys, MD, PhD, the situation in Lithuania is concerning – nearly 20% of the population is diagnosed with obesity. Furthermore, the condition is more prevalent among women than men. Dangerous weight gain adversely affects overall health, metabolism, mental state, and mobility, while a decline in quality of life further exacerbates the disease’s progression.

Doctor D. Danys responds to questions about obesity.

Why do people suffer from obesity? What factors most often contribute to the onset of this disease?

Obesity is not caused by a single reason but a complex of reasons that lead to weight gain. The main factors include harmful lifestyle habits, a lack of healthy nutrition, insufficient physical activity, decreased sleep quality, stress, deteriorated mental health, comorbid diseases, and heredity.

When should a person who is overweight start to worry?

Care for one’s health should not only start when we already have an increased BMI. Prevention is one of the key success factors in fighting obesity. Cultivating a healthy lifestyle should be developed throughout one’s entire life.

The risk of obesity to a person’s health. Why is it essential to treat this condition?

As this disease progresses, there is a significant risk of developing other illnesses such as heart and vascular diseases, type 2 diabetes, various types of cancer, fatty liver disease. There is also an increased risk of depression, eating disorders, primary arterial hypertension, asthma, sleep apnea, polycystic ovary syndrome, increased chances of infertility, and a risk of developing osteoarthritis. This entire complex of diseases also leads to a shortened lifespan.

What are the methods of treating obesity? Are the first steps exercise and a healthy diet? What to do if these measures do not help lose weight?

The most important treatment methods include dietary adjustments, increased physical activity, and changing lifestyle habits. If there’s no effect, treatment with medications that suppress appetite may be prescribed later. If there’s still no result, then surgical treatment methods are applied. The most crucial step is to try to maintain the weight after losing it. This is the hardest stage for most people fighting obesity. Developing healthy lifestyle habits and improving the quality of life should be priority goals if we aim to combat this disease.

Surgical treatment of obesity. When do you recommend this treatment to a patient, and what is important to know about it?

Surgical treatment may be applied if the BMI is over 35 and there are comorbid diseases associated with obesity, or when the BMI exceeds 40. In this case, the patient should be referred for a consultation with an abdominal surgeon about the possibilities of bariatric surgery. Patients typically undergo the following tests: endoscopic examination of the stomach – gastroscopy, ultrasound of the abdominal organs, and additional blood tests aimed at assessing whether there are any severe comorbid endocrine diseases, liver damage, or other conditions that would preclude surgical treatment. Depending on the predominant pathology, consultations with specialist doctors – a dietitian, psychiatrist, endocrinologist, cardiologist, and specialists in other fields – are important before the operation. Preparation for stomach reduction surgery can take from several months to several years.

What makes surgical treatment for obesity specific, and what are the newest methods being applied at your clinic?

Obesity treatment often requires a team approach, with dieticians playing a central role in managing the condition. Experienced dieticians at the clinic specialize in cases of obesity, often providing consultations remotely. Surgical treatment for obesity is considered when other methods (diet and physical activity adjustments, medication, or intragastric balloon implantation) have been tried but were unsuccessful in achieving desired weight correction goals, or when the disease tends to recur, as weight returns. In such cases, surgical treatment is the most effective option. The two most common types of surgeries are gastric sleeve and gastric bypass. The choice of surgery is usually made on an individual basis. For those with increased acidity, gastroesophageal reflux, or metabolic syndrome, the bypass surgery is often chosen, while the gastric sleeve is preferred in other cases.

How can one avoid being overweight? What measures or methods can help?

To avoid overweight, the goal is to eliminate risk factors as much as possible, meaning changing harmful lifestyle habits. Important factors include proper nutrition, reduced stress levels, better sleep quality, behavior therapy, and physical activity. Above all, it’s crucial to find time for oneself, work on self-improvement, and remember that health is the most valuable asset in today’s world.

The article was first published on 07.03.2024 in the regional news platform ETAPLIUS. You can find the original version here.