Obesity

 What is obesity?

Obesity is a chronic disease involving an accumulation of excess fat sufficient to harm health. Individuals are considered obese if their Body Mass Index (BMI) is 30 or higher. Obesity results when the size or number of fat cells in a person's body increases. Obesity is often confused with being overweight. It is important to understand the difference because obesity is a disease and a serious life threat.

How will I know if I am obese?

The first thing you need to do is to find out whether or not you are overweight, and if you are, by how much? To do this you have to calculate your Body Mass Index (BMI). If your BMI is above 23 you are overweight and if it is above 30, then you are obese.

What is Body Mass Index (BMI)?

BMI is a mathematical formula that expresses the ratio between a person's body weight and height. BMI = weight in kg / height in m2

A BMI of

25 kg/m2  >         Overweight

30 - 34.9kg/m2  =        Obese

    > 35kg/m2      =        Morbid Obesity

What is Morbid Obesity?

Morbid obesity is a chronic, lifelong, genetically-related disease. It is defined by a BMI of 35 or above. When obesity becomes morbid, the excess weight puts life at risk. Morbid obesity is associated with a large number of debilitating and life-threatening disorders that have an impact on health and quality of life, while shortening life span.  

What are co-morbidities?

Obesity being a chronic disease is associated with a host of illnesses that seriously compromise health and reduce life span. These illnesses are called co-morbidities nordstrom promo code 2014 and include life threatening conditions like Type 2 diabetes, high blood pressure, cancer, high cholesterol, joint pains, snoring/sleeping disorders (sleep apnoea) etc. When obesity becomes morbid these medical problems become life-threatening and the risk of dying prematurely from these diseases increases.

What is obesity/weight loss surgery?

Studies have shown that obesity surgery is the only proven method to lose weight and keep it off in the long term, when all other therapies have failed. Obesity surgery significantly decreases mortality rates and prevents the development of new obesity-related health conditions in morbidly obese individuals. It completely resolves or improves obesity-related co-morbidities. Risk of death for morbidly obese individuals is 89% higher if they decide not to have surgery.

How does obesity surgery work?

Changing the energy balance is the key to weight loss. Your energy balance is the relationship between how much food (calories) is absorbed and how much energy (calories) is used by your body.

            Energy Balance =                    food intake (calories)____

                                                     Energy expenditure (calories)

Obesity surgery reduces excess weight by one of the following mechanisms:

-     reducing food intake (calories)

-     reducing food intake (calories) and making you absorb less of the food you consume

-     reducing food intake (calories) moderately and making you absorb only a small part of the food (calories) you do eat

Am I a candidate for weight loss surgery?

Yes. If you meet one or more of the following criteria:

-     Your BMI is 35 or above

-     Or your BMI is 30 or above and you have one or more obesity-related health conditions (e.g. type 2 diabetes, heart problems, joint problems,etc.)

-     You have previously attempted to lose weight by non-surgical methods, for example with diet, exercise, medication

-     You do not have any hormonal disorders responsible for excessive weight

-     You are willing to make a life long commitment to exercise and nutritional guidelines

What are the different options for weight loss surgery?

The procedure falls into three major categories;

            1. Restrictive procedures e.g. gastric sleeve resection, adjustable gastric banding; these operations reduce the size of stomach so that it can accommodate less food.

            2. Malabsorptive Procedures e.g. biliopancreatic bypass; these operations shorten the digestive tract to limit the number of calories that can be absorbed.

            3. Combined Restrictive/Malabsorptive procedures e.g. gastric bypass

 What are the ill effects of a reduced size of the stomach? 

Apart from possible vitamin B12 and iron deficiency there are no adverse effects of a reduced stomach size. This has been observed with partial, sub-total and total resections of the stomach for various diseases where part or all of stomach is removed. These deficiencies will be taken care of with supplements.

   How much weight can I expect to lose?

On an average you will lose at least 50-80% of the excess body weight in the first year.

What will be the health benefits of this surgery?

Weight loss surgery can eliminate or improve most obesity related medical problems like diabetes, hypertension, high cholesterol, gastric reflux, muscle and joint pains, snoring, breathing difficulties etc. It will improve your body image and reduce the symptoms of depression. It is also associated with improved fertility and favorable pregnancy outcomes.

But what is most important is the ability to live life to the fullest. You will now be able to do all those little things that look so normal, but you can't do right now - for example playing with your children, finding clothing that fits and looks good and finding comfortable forms of travel and accommodation.

Can I get pregnant after this surgery?

Yes. This is one of the benefits of obesity surgery, as weight loss improves fertility. However, it is recommended to avoid pregnancy during the period of rapid weight loss i.e. the first 12 months.

 

What is involved in preparing for surgery? 

You will undergo a thorough medical and anaesthetic evaluation to assess your eligibility for weight loss surgery. Your commitment to a changed life style and behaviour modification are extremely important as is the support of your family and friends. 

How will the surgery be performed?

The operation is done laparoscopically. This involves small incisions, (usually five) varying in size from 5mm to 1 inch and the procedure is carried out with the help of a camera and special instruments. The benefits of this technique over the conventional open method are:

            - less postoperative pain

            - lower chances of wound infection

            - better cosmetic result

            - an earlier return to pre-surgical levels of activity

How long will it take for me to recover after surgery?

Most patients will stay in the hospital for three days. You will be discharged when:

            - You are able to ingest sufficient fluids to prevent dehydration

            - You have no fever

            - You have adequate pain control with medication

You will be able to enjoy your regular routine in a week to ten days time. 

How will my diet change after surgery? 

Our nutritionist will discuss the diet plan with you before you will be discharged. However, you will have to prepare yourself to an altered eating pattern to maintain a healthier life style and dedicate yourself to following some proven guidelines for long term success. While it may be a challenge at first, it will help you enjoy the maximum benefits of your surgery. What is most important is that you adhere strictly to your dietician and surgeon's recommended guidelines.

After the procedure, you will be on a liquid diet first, followed by blended or semi-solid foods. After that, you will gradually move back to a more regular diet of healthy, low fat, low calorie foods.

Following the dietary guidelines does not mean that you won't be able to enjoy your life anymore. You will be able to go out and eat with your family and friends. You will just need to learn new eating habits, which will help you not to overeat and have unpleasant side effects.

Will liposuction help in reducing weight?

Liposuction is a body sculpturing procedure. It involves removal of fat lying under the skin only. In contrast, following obesity surgery there is a generalized loss of fat and there is restricted intake of food (calories)which helps in achieving sustainable weight loss.

Will a tummy tuck help in losing weight?

Tummy tuck (dermolipectomy) entails removal of excess skin and fat in a pendulous abdomen. Again, this is just localized removal of fat and has no effect on fat in other parts of the body.

Will I keep losing weight forever?

Your weight loss depends on the balance between calorie intake and its expenditure. If you reach your target weight, this can be maintained with a sensible diet and your weight will remain constant.