How to Lose Weight? Types of Weight Loss Surgery & Risks

Obesity is a medical condition in which excess body fat accumulates to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. An increase of 20% or more above the “ideal body weight” is the point at which excess weight becomes a health risk. India is now facing an epidemic of obesity with about 5% of its population having morbid obesity (NFHS 2007). Asian-Indian populations have a higher total and central fat for a given body weight when compared to matched Caucasian populations. Indians are genetically susceptible to obesity especially around the waist.

What Causes Obesity?
Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity and genetic susceptibility although a few cases are caused primarily due to hereditary causes, endocrine disorders, medications or psychiatric disorders.

Morbid Obesity
Morbid obesity is a complex multi factorial, chronic disease, where weight and symptoms build up slowly over time. Obesity becomes “ Morbid” when it reaches the point where it has an adverse effect on health, particularly causing heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer and osteoarthritis. Class II and class III obesity are considered morbid obesity.

Body Mass Index (BMI) is a tool to measure the extent of obesity, where weight and height are used in a formula. (Weight/height in meters2)

Classification of Obesity
  • Overweight (pre-obese) if BMI is between 25-  29.9
  • Class I Obesity if BMI is between 30- 34.9
  • Class II Obesity if BMI is between 35 – 39.9
  • Class III Obesity if BMI is =/>40
Overweight and Class I Obesity can usually be treated with diet modification, exercise and behavioural changes and do not require surgery. Class II and III obesity require bariatric surgery.

Health Risk of Morbid Obesity
Risk of early death is doubled compared to non- obese individuals. The risk of death from diabetes or heart attack is five to seven times greater. Social, psychological and economic effects of morbid obesity, however unfair are real and can be especially devastating.

Common Health Risks Associated with Obesity:
  • Type 2 Diabetes Mellitus
  • Sleep apnoea
  • Hypertension
  • Hypercholesterolemia
  • Increased risk of heart attacks
  • Increased severity of symptoms of asthma
  • Gastro esophageal reflux disease
  • Stress incontinence
  • Low back ache and joint pains
  • Polycystic disease of the ovary
  • Decreased fertility
How to Beat Obesity
Obesity can be treated. It requires multi-disciplinary assessment by endocrinologist, psychiatrist, cardiologist, bariatric surgeon, dietician and others depending on the associated conditions.

Treatment is Patient Specific

Medical management:
  • Psychological support
  • Diet, exercise and behavioural therapy     
  • Medicines
Bariatric Surgery
All types of bariatric surgeries are done under general anaesthesia. These are minimally invasive surgeries which require a short stay in hospital, recovery after surgery is faster and resumption of routine activities is also possible earlier. Since such procedures are as the name implies minimally invasive (key hole), there is usually less blood loss and damage to tissues, hospital stay is shorter (about 2-5 days) and no post-operative ICU stay or bed rest.

Types of Bariatric Surgery :
1.   Gastric banding
2.   Laparoscopic Sleeve Gastrectomy
3.   Gastric Bypass

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