Obesity is a life-long progressive, life threatening condition marked by the excess accumulation of body fat, which can significantly reduce life expectancy.
When weight reaches extreme levels, it is called MORBID OBESITY. Obesity is a multifactorial disease. Simply put it as the result of energy imbalance when the energy intake is higher than the energy output.
The treatment therefore is directed at decreasing the energy intake and increasing the energy output. Obesity is often a misunderstood word. If one has to be cured of obesity one must begin with classifying him/herself.
People whose BMI is between 23.5 – 27.5 are classified as overweight, if not tackled in time, overweight people can easily become obese. If your BMI is between 27.5 – 32.5 you fit into Grade I Obesity category.
It is important to be very careful with your weight; at this stage there is tremendous scope to get back to your ideal weight yet there are equal chances to slip into Grade II Obesity.
Grade II Obesity is often symptomatic; most patients would have had developed co-morbidities at this stage. Type 2 Diabetes, hypertension, sleep apnoea, cardiac problems joint pains are some of the most common co-morbidities for these individuals. It is very important that one immediately takes reversal action at this stage as this condition could lead to morbid obesity or any other fatal illness. If one doesn’t show any symptoms of co-morbidities one can certainly reduce their weight with diets and exercise and a great amount of will power. For those with co-morbidities Bariatric surgery is the only and best option.
How can Obesity affect you?
Obesity is rarely just a physiological problem .This disorder has far reaching effects; physiological, psychological and social. On the physical front, obesity can lead to several complications that could be fatal or incapacitating if left untreated.
People with BMI beyond 37.5, fall in the last and the most dangerous category called Grade III or Morbid obesity. At this stage diets and exercise deliver negligible results. Most patients would have had developed more than one co-morbidity at this stage, many are even rendered immobile. Corrective action at this stage is imperative, the only clinically proven way for morbidly obese people to lose and maintain weight is bariatric surgery.
Obesity is also defined by waist size - over 90 cm in males and over 80 cm in females.
Some of the most common diseases that are directly and indirectly linked to obesity are:
- Type II Diabetes
- Heart Disease
- Liver and kidney disorders
- Joint Pain/Osteoarthritis/Gout
- Respiratory disorders
- Gastro-esophageal reflux disease
- Certain cancers
- Sleep Apnea
- Depression and anxiety disorders
The treatment protocol for treating obesity is as follows:-
- Lifestyle modification
- Diet – when BMI 23 32.5
- Exercise – when BMI 23 32.5
- Drugs (when BMI >23, when lifestyle changes fail)
- when BMI >32.5 with comorbidity
- BMI >35.0 with or without comorbidities.
(like Diabetes Mellitus, Hypertension etc) .
ARE YOU A CANDIDATE?
For patients who remain severely obese after conventional approaches to weight loss such as diet and exercise , or for patients who have an obesity-related disease, surgery is the best treatment option.
Surgical Treatment options available are :
Laparoscopic Sleeve Gastrectomy:
- Laparoscopic Sleeve Gastrectomy is safer than other procedures. In this procedure, 80% of the stomach is stapled and converted into a long sleeve of about 100-150 ml which induces weight loss by restriction in food intake and early satiety, due to loss of hunger producing hormones.
- Digestion and absorption is normal.
- By eating less the body draws the required energy from its own fat stores and thus you lose weight.
The Roux-en-y Gastric Bypass
- It is a procedure which is both restrictive and malabsortive In this procedure, a small, 15 to 20 cc, pouch is created at the top of the stomach. this forms the restrictive element
- The small bowel is divided. The bilio-pancreatic limb is reattached to the small bowel and the other end is connected to the pouch, creating the Roux limb. This forms the malabsorptive element as no absorption occurs in the segment of intestine bypassed
- The small pouch releases food slowly, causing a sensation of fullness with very little food intake.
- The bilio-pancreatic limb preserves the action of the digestive tract.
Bilio-pancreatic Diversion with Duodenal Switch:
- In this procedure, greater weight loss can happen with less dietary compliance from the patient.
- There may be an increased risk of malnutrition and vitamin deficiency and intermittent diarrhea can also occur.
- Constant follow-up is needed for this procedure in order to monitor for complications
It is a procedure which is done by placing a band in the upper part of stomach dividing it into two sections. There is a small opening between the sections allowing the food to pass through. The section above the band acts like the stomach that fills with food quickly. This surgery does not restrict the quality food intake and high calorie liquid intake can hinder weight loss