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Obesity: The growing menace!
Dr. Ramen Goel | Wednesday, May 2, 2012, 08:00 Hrs  [IST]

The sedentary lifestyle most of us lead today has come with a heavy price – the burden of obesity, one of the greatest health threats to the modern world. Statistics reveal that around 14 per cent to 18 per cent of the population in India suffer from obesity.

A study by the Organisation for Economic Co-Operation and Development (OECD), reveals that, while India has a lower percentage of people suffering from obesity, when compared to other countries, when the actual population is taken into consideration, the effect can be considerable.

Obesity is a condition which results in an increase in the generation of fat cells in the body.  This build up of excess fat is most commonly seen along the waistline. Some of the dangers of obesity are diabetes, hypertension, liver, heart and respiratory diseases, sleep problems, cancer and eating disorders like anorexia and bulimia. Besides this, obese people tend to face frequent emotional and psychological breakdowns.

The sources that heave you down with extra weight come in varied forms. From soft drink commercials to eating at fast food joints; from a sedentary lifestyle to struggling with alcohol, there are many factors that need to be looked into. All these problems can contribute to extreme obesity, which if left unchecked can have far-reaching consequences. The best approach is to control weight gain before it becomes an irreparable problem.

While many solutions like natural remedies, pills and protein drinks are being relentlessly peddled; many doctors note that these can have side effects too. Repeated conservative weight loss attempts can cause muscle mass loss, calcium deficiency and even weight regain in over 90 per cent patients. These people are aggressively pushed into exercises which causes more physical and psychological injuries than any real good.

Hence, in the larger context, one needs to resort to medical means if one suffers from extreme obesity. Bariatric surgery or Metabolic surgery is one such option.

Bariatric surgery
Bariatric surgery comprises of a variety of procedures through which weight loss is achieved. In all the procedures, the size of the stomach is reduced and results in early satiety with the quantity of food consumed.

Gastric band surgery is a common procedure in USA, Australia and is a completely reversible procedure performed laproscopically or through the key hole route. Gastric Band is an uncommon surgery in India due to poor weight loss related to diet inclusive of gravies and curries.

Gastric sleeve surgery is the commonest bariatric procedure in India. This involves removal of 80 per cent of stomach but the food continues through normal intestinal passage. Sleeve has shown excellent weight loss results besides diabetes correction in majority of patients.
 
Gastric bypass surgery
Another trusted procedure is the Gastric Bypass Surgery which is considered the gold standard procedure for weight loss. In addition to reducing the size of the stomach, a part of the stomach and small intestine is bypassed, so that food and digestive juices mix with each other distally. This results in delayed and reduced absorption of nutrients and calories.

Many studies attest to the safety and effectiveness of this weight loss surgery and this is no longer a last-ditch option. With technological advancements the surgery has many takers, be it moderately overweight adults, obese teenagers or people with a normal weight who suffer from difficult-to-control diabetes.

Depending on the type of surgery used, patients lose 50 per cent or more of their excess body weight and maintain that loss for as long as 10 years after surgery.

Studies also reveal that bariatric surgery cures Type 2 diabetes in a majority of patients as well as helps cure symptoms related to sleep apnoea and heart disease, such as high cholesterol and blood pressure.

Who can undergo this surgery?
Guidelines are laid by International Federation for Surgery of Obesity for patient selection. The criteria for patients for the Asia Pacific region are as follows:

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The surgery is usually performed on mentally stable, non alcoholic persons, between 18-65 years age group.

Choosing a surgeon
Various factors should be considered prior to selecting a surgeon for surgery:

  • Experience of surgeon
  • Hospital set up
  • Safety profile of the surgeon
It is important to assess if the surgeon has performed similar surgeries in the past and find out how many of them had major complications. The best approach is to ask a few patients who have been treated by the surgeon.

Post-op care
A daily intake of protein, multivitamin and mineral supplements will prevent any possible nutritional deficiency and heal your lean body mass. Iron and calcium supplements are required as well. A strict diet routine, regular follow ups and a positive mindset can help you continue towards your weight loss goal.

Though the problem of obesity may be taking on giant proportions, timely medical intervention is sure to be a big help. In addition to this, inclusion of the right dietary and exercise practices in your daily life will surely keep you in good stead.


(Author is head of Bariatric Surgery for Nova Medical Centers, Mumbai)

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