Obesity is a medical condition associated with the accumulation of excess fat in the body, which in turn can have negative effects on health. Obesity predisposes or increases the chances of a person developing certain diseases like heart disease, hypertension, type2 diabetes, hypercholesterolemia, obstructive sleep apnea, polycystic ovarian syndrome, certain types of cancer,and osteoarthritis. Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, and genetic susceptibility. A few cases are caused primarily endocrine disorders, medications, or mental illness. Body mass index – BMI ( calculated from a person’s weight and height) is a physical measurement that is commonly used to assess the extent of obesity. A person with a BMI of 25 – 30 is said to be overweight, while one above 30 is considered obese.
When a person has a BMI of more than 40, he/she is said to have morbid obesity. Morbid obesity increases the risks of developing multiple diseases as mentioned earlier. Obesity can be prevented by a proper lifestyle and the main treatment revolves around proper dietary and lifestyle changes. Surgical treatment is recommended in those who have failed to respond to dietary and lifestyle changes.
Who can undergo Obesity surgery
BMI ≥ 40, or more than 100 pounds overweight.
BMI ≥35 and at least two obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
Patients who have not found benefit with other medical weight reduction techniques
The person should have been obese for a continuous 3 to 5 years
The person has to be psychologically sound
Management Of Obesity and related disorders
Once you have been diagnosed with Obesity and if you have other obesity-related diseases like hypertension, diabetes mellitus or Obstructive Sleep apnoea, your doctor would advise you on a diet plan to shed excess calories, along with an appropriate exercise routine as well. Meanwhile, you will also be suggested blood tests to look for other endocrine or metabolic causes of weight gain like hypothyroidism orsteroid imbalances.
Your doctor would reassess you after a certain period of dietary modification and exercise routines. If you have not found significant benefit from these and if your blood tests are within normal limits, based on your BMI your doctor would suggest the appropriate surgical treatment necessary.
Bariatric surgery procedures
Bariatric surgical procedures cause weight loss by restricting the amount of food the stomach can hold, causing malabsorption of nutrients, or by a combination of both gastric restriction and malabsorption. Bariatric procedures also often cause hormonal changes. Most weight-loss surgeries today are performed using minimally invasive techniques
The most common bariatric surgery procedures are adjustable gastric band, sleeve gastrectomy gastric bypass and biliopancreatic diversion with duodenal switch.
The Adjustable Gastric Band – often called the band –involves an inflatable band that is placed around the upper portion of the stomach, creating a small stomach pouch above the band, and the rest of the stomach below the band
TheLaparoscopic Sleeve Gastrectomy – often called the sleeve – is performed by removing approximately 80 percent of the stomach. The remaining stomach is a tubular pouch that resembles a banana
The Roux-en-Y Gastric Bypass – often called gastric bypass – is considered the ‘gold standard’ of weight loss surgery.
There are two components to the procedure. First, a small stomach pouch, approximately one ounce or 30 milliliters in volume, is created by dividing the top of the stomach from the rest of the stomach. A part of the small intestine is connected to this part of the stomach bypassing a significant length of the small intestine.
BiliopancreaticDiversion with Duodenal Switch (BPD/DS) Gastric Bypass
TheBiliopancreatic Diversion with Duodenal Switch – abbreviated as BPD/DS – is a procedure with two components. First, a smaller, tubular stomach pouch is created by removing a portion of the stomach, very similar to the sleeve gastrectomy. Next, a large portion of the small intestine is bypassed.
All these procedures are performed by the laparoscopic method and are associated with weight loss in the range of 40 – 70% over a period of 2- 3 years. Each type of procedure has its own advantages and disadvantages and your surgeon will select the procedure that suits you based on your age and physical fitness levels.
Benefits of Bariatric Surgery
When combined with a comprehensive treatment plan, bariatric surgery may often act as an effective tool to provide you with long term weight-loss and help you increase your quality of health. Bariatric surgery has been shown to help improve or resolve many obesity-related conditions, such as type 2 diabetes, high blood pressure, heart disease, and more. Frequently, individuals who improve their weight find themselves taking less and less medications to treat their obesity-related conditions.
Significant weight loss through bariatric surgery may also pave the way for many other exciting opportunities for you, your family, and most importantly – your health
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