Obesity

.: PREFACE
ÖN SÖZ
PREFACE
Doç. Dr. Dilek SOYSAL
İzmir Ekonomi Üniversitesi Tıp Fakültesi, İç Hastalıkları ABD, İzmir, Türkiye
Article Language: TR
Bizler, obezitenin Endokrinoloji ve Metabolizma Bozuklukları, İç Hastalıkları, Kardiyoloji, Gastroenteroloji ve Hepatoloji, Göğüs Hastalıkları, Bariyatrik ve Plastik Cerrahi ve birinci basamak sağlık hizmetleri olmak üzere tıbbın birçok branşıyla ilişkili olması nedeniyle, bu konuyu ''OBEZİTE'' başlıklı kitabımızda ele aldık.

Bu kitabımızda yazarlarımız, obezite ile ilişkili klinik durumların, tıbbi ve cerrahi tedavilerin yanı sıra, obezitede hücre sinyal iletimini, obezitede hücresel metabolizmayı, genetik ve epigenetik faktörleri, obezite-inflamasyon-kanser üçgenini, obezitede kardiyovasküler ve endokrin sistem dışı morbidite ve mortalitenin mekanizmalarını, obezite ve mikrobiyota ve obezite ve COVID-19 ilişkisini, COVID-19 pandemisinde obezitenin dijital sağlık teknolojileri ile yönetimini de ele aldılar. Obezite kitabımıza yurt dışından katkı veren meslektaşlarımız da oldu ve özellikle birinci basamak sağlık hizmetlerinde obeziteye genel yaklaşımı, birinci basamak sağlık hizmetlerinde obezite ve İngiltere deneyimini ve ekolojik bir halk sağlığı sorunu olarak obeziteyi tartıştılar.

Obezite, genetik, metabolik, davranışsal, çevresel ve sosyokültürel nedenleri olan küresel bir sağlık sorunudur. Obezitenin klinik komplikasyonları arasında kardiyovasküler ve metabolik hastalıklar, kas-iskelet sistemi bozuklukları, uyku apnesi, malignite yer almaktadır. Obeziteden kaynaklanan psikolojik sağlık sorunları da bireyin yaşam kalitesini önemli ölçüde etkilemektedir. Tüm dünyada yetişkinlerin yaklaşık %13 ile 20'sinin obez olması ve prevalansın artmaya devam etmesi nedeniyle obezitenin kronik ve ilerleyici bir hastalık olduğu söylenebilir.1 Günümüzde obezite önlenebilir ölümlerin en yaygın nedenlerinden birisi olarak kabul edilmektedir.

Doktorlar, hastaları 6 ayda %10 kilo kaybı gibi mütevazı bir kilo verme hedefi için teşvik etmelidir. Bu miktar; ulaşılabilir olduğu ve obeziteye bağlı sağlık sorunlarında azalma ile ilişkili olduğu için önerilir.

Kilo yönetiminde birçok kişi hızlı bir çözüm ararken, en etkili tedaviler kademeli, uzun vadeli bir yaklaşım gerektirir. Etkili yöntemler arasında diyet, orta düzeyde fiziksel aktivite ve davranış danışmanlığı başta gelmektedir. Bu yöntemlerin tek başına değil ama çok bileşenli olarak uygulandıklarında kilo verebilmek için başarılı oldukları kanıtlanmıştır. ''Sihirli'' bir formül bulunmasa da, kilo vermek için gerekli olan diyet, fiziksel aktivite veya davranış değişikliği bileşenleri için kılavuzlar oluşturulmuştur. Ayrıca yaşam tarzı değişikliklerini bireyin ve toplumun yaşamına dahil edecek halk sağlığı politikaları, obezitenin yönetimini büyük ölçüde kolaylaştıracaktır.

Birinci basamak sağlık hizmetleri ve hekimliği başta olmak üzere, fazla kilo ve obezitenin taranması ve belgelenmesinin cinsiyet, yaş veya tıbbi geçmişe bakılmaksızın rutin bir uygulama olması önerilmektedir.

Bizler, Türkiye Klinikleri'nin ''Obezite'' başlığı ile okuyuculara ulaştırdığı bu kitabın yararlı olmasını diliyoruz. Kitabın oluşturulmasında yer alan bölüm yazarlarına, Türkiye Klinikleri'nin yöneticilerine, editörlerine ve çalışanlarına teşekkür ediyor, yazarlarımızla birlikte her branştan meslektaşlarımıza sevgi ve saygılar sunuyoruz.

Saygılarımızla.

Doç. Dr. Dilek SOYSAL
Editör

KAYNAK
1. Liuzzo G, Galiuto L. GLP-1 receptor agonists: fighting obesity with an eye to cardiovascular risk. Eur Heart J. 2021;42(17):1652-3. doi: 10.1093/eurheartj/ehab175.
Since obesity is related to many branches of medicine, especially Endocrinology and Metabolism Disorders, Internal Medicine, Cardiology, Gastroenterology and Hepatology, Chest Diseases, Bariatric and Plastic Surgery, and primary health care services, we discussed the subject of obesity in our book titled ''OBESITY''.

In this book, our authors discussed obesity-related clinical conditions, medical and surgical treatments, as well as cell signaling in obesity, cellular metabolism in obesity, genetic and epigenetic factors, the obesity-ınflammation-cancer triangle, mechanisms of morbidity and mortality in obesity excluding the cardiovascular and endocrine system, relationship between obesity and microbiota, and obesity and COVID-19, and management of obesity with digital health technologies in the COVID-19 pandemic. We also had colleagues from abroad who contributed to our obesity book. They also discussed the general approach to obesity, particularly in primary care, obesity in primary care and the UK experience, and obesity as an ecological public health issue.

Obesity is a global health problem with genetic, metabolic, behavioral, environmental and sociocultural causes. Clinical complications of obesity include cardiovascular and metabolic diseases, musculoskeletal disorders, sleep apnea, and malignancy. As approximately 13-20% of adults are obese and its prevalence continues to increase, it can be said that obesity is a chronic and progressive disease.1 Psychological health problems caused by obesity also significantly affect the quality of life of the individual. Obesity is now recognized as one of the most common causes of preventable death.

Physicians should encourage patients for a 10% weight loss over 6 months, which is a modest achievable weight loss, and is associated with a decrease in obesity-related health consequences. While many people seek a quick solution for weight management, the most effective treatments require a gradual, long-term approach. Diet, moderate physical activity and behavioral counseling are among the most effective methods. These methods have proven to be successful for weight loss when applied as a multi-compo- nent, but not alone. While there is no "magic" formula, guidelines have been established for the components of diet, physical activity, or behavior change needed to lose weight. In addition, public health policies that will include lifestyle changes in the life of the individual and society will greatly facilitate the management of obesity.

It is recommended that screening and documentation of overweight and obesity should be a routine practice, regardless of gender, age or medical history, especially in primary health care and medicine.

We hope that this book, which is delivered to the readers by Türkiye Klinikleri with the title of ''Obesity'', will be useful. We would like to thank the authors of the chapters, the managers, editors and staff of the Türkiye Klinikleri who took part in the creation of the book, and extend our respect and love to our colleagues from all branches. Kind Regards.

Assoc. Prof. Dr. Dilek SOYSAL
Editor

REFERENCE
1. Liuzzo G, Galiuto L. GLP-1 receptor agonists: fighting obesity with an eye to cardiovascular risk. Eur Heart J. 2021;42(17):1652-3. doi: 10.1093/eurheartj/ehab175.

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