Obesity, as defined by the World Health Organization, is the condition of excessive fat mass in the body to the extent that it impairs health. Genetic and environmental factors may be effective in the formation of obesity. Obesity, which is a clinical diagnosis, is diagnosed by doctors who are experts in the field, while people undergo a number of tests.
First, the person’s diet and exercise patterns, appetite control, drug or supplement use are taken into consideration. Then, physical controls including height, weight measurement, heart rhythm observation and routine blood tests are completed. Body mass index calculation and waist circumference measurement are also added to the person’s information. The patient’s disease history is an important step in the diagnosis and treatment of obesity. The diagnosis made as a result of the person’s health history, diseases and other tests evaluated makes the treatment of obesity specific to the individual. Because obesityIt is not just a diagnosis based on weight. A value or a disease in a person’s blood test may be present in one patient and not in another. Or, while a person of the same weight is using a drug that will affect their treatment, the other may not be using it. All these detailed evaluations make the diagnosis and treatment of obesity individual. The fact that the treatment is individualized is the first step in achieving a positive result from the treatment.
Obesity Test
According to the data of the World Health Organization, obesity can be diagnosed with a number of evaluations. These can be listed as follows.
Body Mass Index (BMI): Since body mass index does not evaluate age and gender, it is used for screening and statistical purposes. In the calculation of BMI value, it is calculated by dividing the person’s body weight in kilograms by the square of the height in meters. For example; 1.74 m at 98 kg
For someone who is tall, the body mass index can be found as 32.3 by calculating 98/(1.74*1.74).
There are several classifications determined by the World Health Organization according to body mass index. In this classification, body mass index value can be evaluated in obesity screening. According to this classification, values between 18-24 are normal; If the value rises above 30, the person may be diagnosed as obese. Values above these figures vary according to the degree of obesity.
Obesity in Children
Growth and development in children are followed according to the value expressed as percentile. The percentile, that is, the growth curve, is the table in which the World Health Organization determines the height and weight that children should be according to their age. Head circumference can be evaluated within these values until 3-4 years old. percentile values; It has been determined as 3-10-25-50-75-90-95. Obesity in children can be diagnosed by looking at the percentile chart, not the body mass index in adults. Children above the 85th percentile are considered overweight, and children above the 95th percentile are considered obese.
Waist to Hip Ratio: Waist to hip ratio is another factor evaluated in the diagnosis of obesity. Obesity assessment can be made according to the waist circumference and waist-hip ratios determined by the World Health Organization. First of all, when the waist circumference measurements are evaluated; Waist circumference of more than 80 cm in women and 94 cm in men is risky; 88 cm in women and 102 cm in men and above are diagnosed as obese. Waist to hip ratio is calculated by dividing the waist circumference in centimeters by the hip circumference. If this value is 0.85 in women and 0.90 and above in men, it is considered obese.
Waist to hip ratio has an important place in obesity assessment. As stated in the studies, especially in the type of fat that is defined as abdominal fat around the abdomen, it can invite some diseases because the fat mass around the internal organs increases. These; Insulin resistance , type 2 diabetes, high blood pressure , cardiovascular diseases can be listed among risky diseases in abdominal adiposity. Although abdominal fat is usually more common in men due to hormones, this situation is called “apple-type obesity or male-pattern adiposity”. Since regional adiposity in women is seen more in the hips and hips, this is called “pear-type obesity or female-type adiposity”.
Skin Fold Thickness: By measuring the skin fold thickness in certain areas of the body with a tool defined as a caliper, an interpretation of body fat composition can be made. Obesity was defined as skinfold thickness greater than 38 mm in men and 52 mm in women. However, since this measurement is very sensitive, there may be differences depending on the person making the measurement. In this case, skinfold thickness measurement may play a role in the diagnosis of obesity, but it should not be considered as a diagnostic criterion alone.
Bioelectrical Impedance Measurement: Recently, the most reliable and most frequently used obesity test is body analysis with bioelectrical impedance measurement. It is based on the principle of analysis by applying electricity to the body at very low voltages with the help of hands and feet. While tissues such as muscle and water pass electricity faster, the speed of electricity passing through adipose tissue is slower than other tissues. Therefore, as the body fat tissue increases, the passing electric current slows down, and accordingly, the fat ratio in the body can be determined in the analysis. When the body fat rate is evaluated, the normal ranges of body fat rate in women are 20-30%; in men it is 12-20%. Having a fat ratio above these ranges is a harbinger of obesity.
These diagnostic criteria in obesity alone may not be sufficient for the diagnosis of obesity. For example, although body mass index is usually the first diagnostic criterion for obesity, body mass index may not be considered as the correct diagnostic criterion in athletes and the elderly who are evaluated as having more or less muscle than normal according to studies. In this respect, a holistic approach to all obesity test classifications is important for the diagnosis of obesity.
Types of Obesity
It is possible to mention several types when it comes to obesity. Types of obesity that can be formed according to fat distribution and body mass index can be listed as follows.
Obesity by Fat Distribution
It is a classification based on the regional evaluation of excess fat in the body. Excessive fat in the abdomen is defined as apple-type obesity or male-type adiposity. Since excessive fat on the hips and hips is usually seen in women, it is called pear-type obesity or female-type adiposity. In the type, which is defined as mixed type obesity, there is no regional increase, but lubrication is observed in the whole body and internal organs. Abdominal lubrication, which is one of the regional lubrication types, usually causes lubrication of internal organs and can cause some diseases.
Obesity by Body Mass Index
According to the body mass index classification, values of 30 kg/m2 and above are considered as obesity. While the body mass index of people who are considered as moderately obese is known as 30 – 34.9 kg/m2, this value is 35 – 39.9 in severely obese people. While obesity reduces the quality of life in these classes, it can also be the cause of some diseases. In this type of obesity, which is classified as morbidly obese and at a very serious level, the body mass index is 40 and above. Although there are health problems similar to other types of obesity, the quality of life is seriously reduced. In morbid obesity, movements are also significantly restricted. In addition, studies have shown that morbidly obese women and men have a high risk of death. Morbid obesity can usually be treated using surgical methods.
Obesity is one of the diseases with the highest prevalence in the world. Obesity on its own can cause many diseases, as well as affect the quality of life. However, despite all this, obesity has a cure and can be recycled. In fact, the effects of diseases caused by obesity can either be reduced or completely eliminated by obesity treatment. In this context, you can get a day for examination by applying to our surgery clinics that provide obesity treatment, nutrition and dietetics or obesity surgery treatment in our hospitals.
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