Obesity is a disorder linked to excessive amount of body fat. Obesity is the leading cause to many chronic diseases. There is hope for obese people who do not find bariatric surgery,as the best solution for their disorder. Introduction: Obesity is a medical condition which involves an excessive amount of fat stored in the body due to imbalances between energy intake and consumption regulated by neuroendocrine system[1]. There are several factors that contribute to obesity; heredity, combination of high fat diets with diets rich in easily absorbed carbohydrates, lack of physical activity as well as sleep deprivation[3],[5]. In addition to this, hypothyroidism, Cushing’s syndrome,Prader-Willi syndrome and drugs such as tricyclic antidepressants, corticosteroids, estrogen-containing contraceptive pills are known to cause weight gain too[4],[7]. In order to maintain a healthy weight, a man needs approximately 2.500 calories a day, whereas an active woman needs 2000 calories [3]. Obesity is measured by BMI( Body Mass Index), a value derived from the height and the mass of a person[6]. BMI of 18.5 to 24.9 kg/m2 is considered normal, whereas BMI > 30 kg/m2 defines obesity[6]. Statistics: Latest data show that obesity (BMI >30 kg/m2) affects every segment of the world population [8]. Approximately 2,1 billion people are obese, which means obesity affects 30% of world population[8]. According to the World Population Review, Nauru, an island country in Micronesia is listed as the first one in the world, 61% of its population is reported to have a BMI higher than 30 followed by Tonga and Samoa. America is ranked 12th and London 36th [8]. Future predictions about obesity seem to be not very optimistic; by 2020 41% of men and 36% of women will be obese, giving a rise in the prevalence of obesity-related high blood pressure, obesity-related stroke as well as obesity-related diabetes [9]. Diagnosing, Medication and Complications: Quantifying obesity using BMI is the first step in order to asses a great plan for its treatment. Waist circumference measurement is one of the most accurate and simplest way to measure abdominal fat [7]. Waist circumference greater than 102 cm in men or greater than 88 cm in women is a sign of high risk of metabolic and cardiovascular complications of obesity[7]. The excess amount of adipose tissue distributed due to obesity seems to be very harmful for the liver[7]. Many factors that are released from adipose tissue such as: adipokines, adiponectin and resistin may be higher in the liver, this induces high insulin resistance which develops type 2 diabetes [7]. In addition to this, cirrhosis and non-alcoholic steatohepatitis are listed as complications due to liver fat accumulation[7]. Obese people suffer from sleep apnea, respiratory failure due to restricted ventilation caused by mechanical effects of weight[8]. This may cause urinary incontinence and varicose veins too [8]. Management of Obesity: There are several options for treating obesity[7]. Eating healthy and increasing physical activity are highly recommended[7],[10]. Patients who tend to lose weight rapidly are required to follow a supervised low-calorie diet, which sometimes may be followed by headache, nausea, diarrhea and orthostatic hypotension[7]. These days, a huge investment has been made by pharmaceutical industry in order to fight obesity[7]. Orlistat( pancreatic lipase inhibitor) and Sibutramine (Serotonergic in CNS) are currently recommended[7]. Bariatric surgery is the final step that obese people can take in case options above are inadequately effective[7]. This surgery is performed laparoscopically and tends to be the most effective way to treat obesity[7],[10]. The mechanism is based on disruption of peptides like ghrelin from stomach or oxyntomoduline or glucagon-like-peptide from small bowel, by this it enhances satiety signals in the hypothalamus, reduces weight, and improves body mechanisms to use sugar after eating.[7],[10],[11]. Fig 1. Bariatric surgery procedures. A Vertical banded gastroplasty. B Laparaoscopic banding C Roux-en-Y gastric bypass. Image adopted from [7]. Latest research: Knowing that bariatric surgery may be followed by: chronic nausea, abdominal pain, vomiting, many people are against it, a group of researchers at Imperial College London leaded by Professor Tricia Tan wanted to know if a subcutaneous injection of combination of three hormones (GOP Mixture) could reduce high glucose levels and help weight loss [11] This trial included patients on GOP treatment, patients who received bariatric surgery, with prediabetes, diabetes, and patients who received saline placebo[11].Studies have shown that after four weeks patients on the GOP treatment had lost approximately 4.5 kg. This shows that there is a chance to gain a weight loss and improve blood glucose without need to undergo bariatric and experience its side effects[11]. Conclusion: This research brings new hope for people with diabetes and obesity people since the GOP injection led to great improvements to blood glucose and weight loss. ✵COPYRIGHT: This article is the property of We Speak Science, a non-profit institution co-founded by Dr. Detina Zalli and Dr. Argita Zalli. The article is written by Rexhep Sahatçiu, University of Prishtina, Kosovo. ✵References: 1.https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742 2. https://www.who.int/topics/obesity/en/ 3.https://www.nhs.uk/conditions/obesity/causes/ 4. https://www.healthdirect.gov.au/what-causes-obesity 5.Harrison’s Principles of Internal Medicine 6. https://en.wikipedia.org/wiki/Body_mass_index 7. Davidson Principles and Practice of Medicine 21st edition 8.http://worldpopulationreview.com/countries/most-obese-countries/ 9.https://www.theguardian.com/society/2010/feb/16/adult-obesity-rises 10.Kumar& Clarks Clinical Medicine- Eight edition. 11.https://www.sciencedaily.com/releases/2019/08/190806101531.htm
