Obesity is an excessive accumulation of body fat in the body. This excess body fat is a health hazard. because it is a major risk factor in many chronic diseases such as diabetes, cardiovascular disease or cancer.

Problem of being overweight and does it inevitably go through surgery to heal? Is the bariatric surgery reimbursed by the mutual? Let’s try to unravel these frequent questions.

BMI, calculation and classification of overweight
The World Health Organization (WHO) defines obesity as a chronic disease in which excessive accumulation of body fat poses a health risk . The standard used to measure body fat is BMI, the body mass index, which relates a person’s height and weight. The higher the BMI, the more body weight there is, leading to weight related risks.

The BMI (Body Mass Index) is calculated by dividing the weight in kg by the height in m². Thus, a person measuring 1m82 and weighing 83kg will have a BMI of 25.06 kg / m² (calculation: 83kg / 1.82m ² = 83 / (1.82 x 1.82) = 25.06).

There is already talk of excess weight from a BMI greater than 25, but the classification of body build is as follows:

For a BMI less than 18.5, it is considered that there is thinness.
A BMI between 18.5 and 25 indicates a healthy weight.
A BMI between 25 and 30 supposes an overweight.
A BMI between 30 and 40 indicates that there is obesity.
For a BMI greater than 40, we even talk about morbid obesity.
Overweight (BMI between 25 and 30) is not yet worrying, nor dangerous for health, however, it is better to monitor yourself to avoid getting into obesity.

Be careful, the BMI is a ‘body mass index’ and not an absolute data. Indeed, it does not distinguish between bone, muscle, water and fat masses. To better understand his body and weight, BMI is insufficient and it may be interesting to weigh on an impedance meter scale (at a dietician , for example). This will tell you the percentage of your weight that is composed of bone mass, fat and muscle to find your ideal weight.

Figures on obesity in Belgium and Europe
In Belgium, almost one in two people is overweight (BMI> 25) and 17% of the adult population is obese.

Obesity affects men more than women and average weight increases with age and is greater after age 50. At the European level, there are three times more obese people than in the 1980s and ten times more in children! The WHO also describes obesity as an epidemic and considers it one of the biggest public health challenges of the 21st century. At present, one in two adults and one in three children are considered overweight in Europe.

Causes of obesity
Our way of life is for many with a sedentary accented and an ‘obesogenic’ food supply, whose intake of fats and sugars is always greater. But everyone is not equal in the balance. If we remain purely objective, weight gain occurs when the energy balance is positive. That is, if one ingests more calories than the body spends energy. The body then stores the surplus as fat. However, many other factors come into play and not everyone is equal in weight gain.

Why? First of all, there are good and less good metabolisms, which require more or less energy to function. With identical calorie intake and physical activity, weight gain will not be the same from one organism to another. At this level, there is not much that can be done, since these predispositions are dependent on genetics.

Other external factors may also promote weight gain.

Psychosocial factors: stress or anxiety related to personal problems, family or work situations lead to weight gain or loss depending on each person.
The excessive sedentariness of our current lifestyle does not promote weight loss.
Taking certain medications can sometimes contribute to weight gain.
Stop smoking: weaning makes us compensate with food.
Hormonal factors, such as during pregnancy or menopause, can cause weight gain.
Diets too restrictive to repeat: the more we deprive ourselves, the more the body will store when we start weight gain or loss depending on each person.
The excessive sedentariness of our current lifestyle does not promote weight loss.
Taking certain medications can sometimes contribute to weight gain.
Stopping smoking: weaning makes us compensate with food.
Hormonal factors, such as during pregnancy or menopause, can cause weight gain.
Diets too restrictive to repeat: the more we deprive ourselves, the more the body will store when we start eating, for the next restriction.
The family legacy and dietary habits instilled from an early age continue our lives.
The over consumption society with its high calorie products and advertising campaigns on every street corner does not help to keep a healthy weight easily.
If, in order to gain weight, one must ingest any more calories in relation to the energy expenditure of the body, all the aforementioned factors contribute more or less according to the individuals.

The dangers of obesity and how to avoid them
If obesity is considered a scourge, it is because it is a preponderant risk factor in the onset of innumerable chronic diseases or serious conditions. Type 2 diabetes, high blood pressure, cardiovascular diseases, cancers … to name only the most common. If in the first degree, due to the loss of mobility or breath, overweight plays more or less innocuous on the quality of life, it can also reduce the hope.

That’s why it’s important for everyone to take responsibility for weight and to be aware of the danger posed by being overweight. Whether it is to keep a healthy weight or lose excess weight before the onset of illness. It is said that losing 5 to 10% of one’s weight already contributes to improving health and reducing the risks of being overweight.

The only good management of obesity is to act on the whole lifestyle by reducing caloric intake and improving energy loss, that is, by increasing physical activity. . Just the wording of the solution can discourage many people who are obese, which is why it is important to be accompanied and to know all the options. Undertaking a weight loss is not always easy, but there are solutions adapted to the severity of each case.

A global approach to losing weight
The first step towards better health is to consult your doctor, a nutritionist or a dietician. After a nutritional assessment and according to your BMI, he or she can advise you on the procedure to follow and accompany you throughout your journey.

Indeed, it is not enough to eat less and too restrictive diets are to be discouraged without medical monitoring. What you need above all is to learn how to eat better, that is to say according to your needs, and to keep these habits in the long run. Then, it is necessary to favor the energetic loss of your metabolism, by starting to move more.

This lifestyle change, often experienced as radical by severe overweight patients, can be destabilizing and difficult. That is why it is essential to accompany him with psychological support, to keep motivation and understand the mechanisms that led to overweight.

Sometimes medications may be prescribed to promote weight loss or bariatric surgery may be considered. But in all cases, these solutions must be accompanied by a change in lifestyle and be part of a comprehensive approach to physical and mental health.

Bariatric surgery: a definitive solution to obesity?
Sometimes bariatric surgery or obesity surgery can help an obese patient lose weight so that he or she regains mobility and learns to eat healthy again. But this is not always the case either and surgery is not the only recourse or a panacea for everyone. In general, these interventions are very invasive for the patient and are sometimes irreversible. It is therefore important to consider all the solutions before using them and to know the issues well.

What are the different surgeries possible to promote weight loss?

More commonly known as ‘sleeve’, this method involves removing a large part of the stomach to reduce it to a tube 2 cm in diameter and a capacity of about 100 ml. It is a restrictive technique used in the treatment of severe or morbid obesity. It aims to significantly reduce the amount of food ingested. First, for lack of space in the stomach, and second, by reducing the feeling of hunger (the hunger hormone, present in the stomach is largely reduced since ⅔ of it have been removed). This operation is irreversible.

Different surgical procedures exist against obesity

Gastric bypass

Bypass or gastric bypass is the most commonly performed obesity surgery. It consists of somehow shorting the stomach. This is divided in two to keep only a small operational part and connect it directly to the small intestine (or small intestine) to bring food. This operation has the effect of dietary restriction – we arrive more quickly to satiety because the remaining volume of the stomach is very small restriction and the malabsorption of fat, which are no longer absorbed by the short circuited portion of the stomach.

Different surgical procedures exist against obesity

The gastric ring

The gastric band is an adjustable ring-shaped prosthesis placed at the entrance of the stomach to reduce the diameter. The ring is connected to a box under the skin, by which one can inflate or deflate the prosthesis to tighten or loosen it. This device requires the patient to eat more slowly and chew the food to not obstruct the passage.

Different surgical procedures exist against obesity

The intragastric balloon or BIG

The intragastric balloon is a non-surgical procedure that, using a gastric tube, deposits a balloon in the stomach which will then be filled with water to occupy a large part of the space. . As a result, the feeling of satiety is felt more quickly and you tend to eat less. The balloon must be removed after 6 to 10 of satiety is felt more quickly and you tend to eat less. The balloon must be removed after 6 to 10 months. This solution is offered in less severe cases or patients who have to lose a few pounds before a more invasive surgery.

Different surgical procedures exist against obesity

When can I get surgery and is it reimbursed by the mutual?
The criteria for claiming an obesity surgery are strict. It should also be recognized that these interventions are not innocuous and do not guarantee, by themselves, weight loss results. A global and interventions are not innocuous and do not guarantee, by themselves, weight loss results. A global and medical care is necessary as well as a real desire to change his lifestyle. Only by changing one’s diet and increasing physical activity for life can one achieve and maintain weight loss.

As well as to be eligible for bariatric surgery, several criteria must be met to qualify for reimbursement of the mutual. At the time of the surgery, you must be at least 18 years old and your BMI must be 40 or higher . If it is greater than or equal to 35 , a reimbursement is possible, but at least one of the following comorbidities must be associated:

diabetes treated with drugs.
Treatment-resistant hypertension defined by blood pressure equal to or greater than 140 / 90mmHg

physician must send a standard form of personal mail notification to the medical advisor.

If you meet these conditions, you must obtain Appendix 77, issued by the INAMI.

Once this document has been received, your mutual may cover a portion of the costs for sleeve gastrectomy, gastric bypass or gastric band surgery, provided that the physician has agreed to this beforehand. No reimbursement is however possible for the intragastric balloon.

Surgery does not cure obesity
In conclusion, remember that bariatric surgery can help to lose weight, but that it is the eating behavior that must be treated in its entirety, as well as a change in lifestyle.

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