ÖZET
Dünya Sağlık Örgütü tarafından, vücutta sağlığı bozacak ölçüde anormal veya aşırı yağ birikmesi olarak tanımlanan obezitenin prevalansı her geçen gün artmaktadır. Hastalığa karşı geliştirilen stratejiler temelinde bireyin yaşam tarzını değiştirmeye yönelik olan davranış terapisinin yanında, diyet tedavisi, egzersiz, tıbbi beslenme tedavisi, farmakolojik ve son çare olarak ise cerrahi tedaviyi önermektedir. Cerrahi tedavi dışındaki yöntemlerin kilo kaybı üzerindeki etkisi yavaştır. Bu yüzden obez hastaların birçoğu hızlı kilo vermek adına obezite cerrahisi yöntemlerini tercih etmektedir fakat; bu yöntemeler başta kilo geri kazanımı olmak üzere taşikardi, fistül, kanama, fıtıklaşma, anastomoz darlığı, gastrik erozyon, ince bağırsak tıkanıklıkları, derin ven trombozu ve pulmoner emboli gibi birçok komplikasyonu da beraberinde getirmektedir. Cerrahi sonrası kilo alımı ve yaşanan komplikasyonlar son zamanlarda yeni arayışlara yol açmış ve tıbbi beslenme ve fitoterapi ürünlerinin kullanımı yeniden bir ümit olarak gündeme gelmiştir. Fitoterapi ürünleri tek başına ya da diğer yöntemlerle birlikte kullanılabilme özelliğine de sahiptir. Doğal obezite karşıtı ürünler; fitokimyasallar, polifenoller, flavonoidler ve fitosteroller gibi fonksiyonel içeriklere sahiptir. Bu alanda kullanılan birçok doğal ürün bulunmaktadır ve bu sebeple farklı sınıflamalar mevcuttur. Fitoterapötikler, etkinliğine göre; yağ yakımını artıran ve metabolizmayı uyaranlar, iştahı baskılayanlar, tokluk hissi yaratanlar, kan şekerini ve insülini kontrol edenler, karbonhidrat ve yağların absorbsiyonunu inhibe edenler, inflamasyonu inhibe edenler şeklindeki sınıflamaya tabii tutulmaktadır. Fakat yine de doğal ürünlerin antiobezite etkinliğini ve etki mekanizmasını aydınlatmak için daha fazla klinik araştırmaya ihtiyaç vardır. Obezite tedavisinde seçilecek yöntemin riskleri ve yan etkileri hasta ile tartışılmalıdır. Hastaya öneriler multidisipliner bir değerlendirmeden sonra verilmelidir. Hastanın mevcut durumuna en uygun ve en az riskli yöntem ile tedaviye başlanmalıdır. Hastanın bu yöntemlerden biri ile zayıflamasının büyük ihtimalle sağlanacağını ama önemli olanın davranış değişikliği ile zayıf kalmanın sürdürülmesi olduğu anlatılmalıdır.
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