There is no perfect treatment for obesity. Conservative treatment, the patient accepts and manages to change their lifestyle, changing diet and so (choosing a calorie version) and physical activity (increasing a constant) is ideal.
There are numerous attempts to prescribe The ideal diet. The fact is that, in the USA, replacing fat with carbohydrates (sugars) did not lead to any result, obesity is increasing spectaculos.Soluţia low calorie intake without having to remove or reduce one or more nutritional components. There calorie diet weight loss programs (600d calories with 40g protein), but it is recommended that they be done under medical supervision. The association constant exercise improves diets result: both walking and gymnastics, and sports such as swimming, canoeing, golf, tennis contribute to a negative caloric balance and reduce the amount of fat mass.
Surgical treatment of obesity may be preceded by or replaced with a minimally invasive, endoscopic, mounting a silicone balloon that occupies part of the stomach, decreasing its capacity and reducing appetite; Most patients lose weight around 4 kg per month. Unfortunately endogastrically can not keep the ball in the stomach than 6-8 months, and if there is a change in the overall scheme of life, the results can be lost over time.
Surgery itself has several variants: restrictive procedures (which attempts to decrease food intake) malabsorptive procedures (which prevents the absorption of nutrients ingested components) and combined processes. The technique currently used in obesity surgery (number of interventions increased 5 times in the last year) is “gastric-banding” (ring perigastric) laparoscopically. Mount laparoscopic (small incision under surveillance by a camera) a silicone ring around the upper part of the stomach, greatly reducing gastric capacity and narrowing the passage of food to 10-12 mm. It is the least invasive method but does not work in patients who consume high calorie food all the time (nuts, chocolate, ice cream, etc.) or high calorie liquid drink (cola, fresh fruit juices, etc.) easily passing perigastric ring. In such cases either the process is called called longitudinal gastrectomy, sleeve gastrectomy, gastric cavity permanently reduces or shorting digestive processes, which decreases intestinal absorption: Gastric bypass laparoscopic- which shrinks the stomach and shortens more bowel function, causing the so restricted, and a malabsorption.
Biliary-pancreatic, and are described by Niccolo Scopinaro, achievable, under certain conditions, laparoscopy. These interventions are more aggressive, are charged with higher risk but may be the last resort in case of super obese can not control food.
Plastic surgery can occur in the first phase, some form of moderate obesity (liposuction, abdominoplasty) especially after digestive intervention to correct functional and aesthetic problems that occur after rapid weakening, major weight loss, addressing in particular excess skin resulting from weight loss.
Dr. Eduard Ursuleanu, specialist surgeon Proestetic Medical Center, Bucharest