The pressing problem in Georgia – Morbid obesity, the important concern of National Center of Surgery

The pressing problem in Georgia – Morbid obesity, the important concern of National Center of Surgery

According to the World Health Organization's information, the majority of the world population is overweight.

Obesity is called a 21st century’s black plague. Obesity is mainly associated with poor nutrition. In addition, excess weight can be caused by chronic stress, insomnia, hypodynamia, genetic predisposition, hormonal disorders and etc.  Scientists say that seated jobs and spending time in front of the TV are dangerous for health, but despite the recommendations, unfortunately, many people forget what kind of threat is immobility.

In the world, approximately 100 million people are diseased with obesity and about 100,000 people have morbid obesity in Georgia. Obesity and excess weight are not just a visual, cosmetic problem and extra kilograms pose a serious threat to health.

How do we fight excess weight in National Center of Surgery? We asked the question to our clinic’s endocrinologist, Ana Chokhonelidze.

On the 24th of November ms. Chokhonelidze presented a report at the third scientific conference called "The Role of Innovations and Modern Technologies in the Development of Medical Practices", which was held in the framework of the event dedicated to National Center of Surgery’s  71st and academician Konstantine Eristavi’s 128th  birth anniversaries.

Endocrinologist states – "Our clinic is equipped with ultramodern laboratory and latest equipment that allows us to properly examine the patient. After the diagnostics, endocrinologist plans individual nutrition for a patient (proper nutrition that is adjusted to the patient's daily routine and doesn’t create a discomfort nor feeling of hunger for a patient). If there’s a necessity, other methods of treatment are selected, it being a medication or surgical treatment”

Bariatric operations are successfully conducted at National Center of Surgery. When is this treatment method selected?


Bariatric surgery is not considered to be a field of plastic surgery, this is a surgery conducted for the correction and prevention of diseases caused by obesity. After the bariatric intervention, accompanied diseases significantly decrease or sometimes absolutely regress. Bariatric interference takes place if the patient's body mass index is > 40 or 35-40 cm and the person has diabetes, type II diabetes and high arterial pressure indicators.

What are our clinic’s statistics in this regard?

For several years now bariatric operations have been successfully conducted in our clinic using ultramodern equipment- bloodless method. If there’s a necessity, intervention is also conducted with an open manner. Operations are performed by experienced surgeons. The patient’s preoperative preparation is ensured by an endocrinologist. If necessary, the clinic's following team of professionals is involved in the patient's pre, as well as post-operative management: cardiologist, gastroenterologist, hematologist, therapist, radiologist, angiologist, neurologist. Post-operatively patients are constantly under endocrinologist’s constant supervision.

What can you tell us about the causes of obesity?

The causes of obesity are an unhealthy lifestyle (improper nutrition, immobility), genetic factors, hormonal disorders, disturbance of sleep phases. 

– How is obesity diagnosed?

Usage of Body Mass Index for assessing adults diseased with obesity. Body Mass Index is calculated by dividing the weight by square height measured in meters. Norm body weight index is 18,5-24.9, excess weight - 25-29,9, class I obesity -30-34.9, class II obesity - 35-39,9, whereas 40 is class III obesity, but body mass index is not a universal diagnostic criterion for adolescents,  people over 65 years old or with excessively developed muscles and pregnant women. Based on the waist measurement: norm < (in men) 94, (in women), < 80. Excess weight 94-102, 80-88, obesity> 102, >88.

– Is there a connection between obesity and genetic predisposition?

Studies have shown that, like many other chronic diseases, there is a link between genetic predisposition and obesity. However, it is possible to develop obesity regardless of genetic predisposition, if a person eats excessively and improperly and isn’t physically active enough.

– Where lies the line between diet and hunger? 

People often arbitrarily begin to fight excess kilograms without a doctor’s involvement. At this time, they turn to non-physiologic, popular diets found on the internet or even hunger, which might end poorly for health. The body has a number of regulatory mechanisms using which it regulates the appetite. Hunger, as well as satiety center is located in the brain and their excitation can take place under the influence of various factors.  Ghrelin (increases appetite) so-called hunger hormone is produced in a stomach, cholecystokinin, so-called satiety hormone is produced in mucosal lining within the small intestine (decreases the appetite), leptin so-called satiety hormone is produced in an adipose tissue. Variety of food, glucose, smell, visuals cause excitation of the hunger center. The satiety signal reaches the brain in 20 minutes. That's why it's necessary to consume food at a slow pace. The body perceives non-physiologic, low calories diet and hunger to be a stress that disturbs various hormone’s physiologic rhythm and regulative mechanisms. This is why in the long term it's a risk factor for gaining weight. The reason is the fact that after the person returns to the usual rhythm of life, s/he gains weight. A diet consisted of calorie intake lower than 800 kcal throughout day and night can be practically considered a hunger. Also, being on a mono (protein) diet for a long time is dangerous for health.

What kind of threat does obesity pose?

Obesity is recognized as a non-infectious epidemic of the XXI century by World Health Organization. It belongs to chronic diseases and is coded based on ICD classification.  Obesity is a psycho-social problem and is found in all ages and social classes. Obesity isn't a cosmetic problem and is connected with other chronic diseases, for example, diabetes, the risks of type 2 are increased by 4, risks of arterial hypertension and varicose veins – tripled. In addition, the risks of hypothyroidism, lung hypoventilation, asthma, sleep apnea, liver fatty hepatosis, colorectal cancer, menstruation cycle disturbance, infertility and libido deterioration increase. Average life expectancy decreases. Arterial hypertension, gestosis, gestational diabetes, fetus’ neural tube defects, premature birth, risk of perinatal lethality increases in pregnant women.

National Center of Surgery address: Tbilisi, Dighomi, Chachava N5.

You may contact National Center of Surgery’s call center at 577 119 119.

In case of any issues, you may contact National Center of Surgery’s endocrinologist Ana Chokhonelidze for consultation at 595 57 43 17.

Wish you health!