OBESITY AND MORBID OBESITY

Many of us are plump (overweight) or fat (obese). Some of us are at the far end of the obesity spectrum (morbid obesity). So how does one define oneself- overweight, obese or morbidly obese?

To do that, you have to know your BMI. This is your weight in kgs divided by your (height in meters).

MORBID (CLINICALLY SERVERE) OBESITY

Morbid Obesity is a condition where body fat accumulates to a level that threatens health and life.

This is traditionally defined as a Body Mass Index of 40 or more, though the current Indian definition is a BMI of 37.5 or more. If a person has a BMl of 32.5 (originally 35) along with diabetes. hypertension or sleep apnoea. It is also a form of morbid obesity.

WHY IS MORBID OBESITY SO DANGEROUS?

Morbid obesity is one of the world’s biggest killers today. Diabetes, high blood pressure, heart disease and cancers arc some of the major forms of its manifestations. It has been seen that a morbidly obese person risks living IS to 20 years less than he or she would otherwise have.

WHAT IS THE BMI APPROACH TO WEIGHT LOSS?

In other words, you want to know why the fat loss methods used in Belle Vue Clinic’s specialised obesity management are the right ones for you. The reason is simple – at BVC, only evidence-based, scientifically proven methods of fat loss are used, whether it is a nutritional guideline. an exercise regime or an operative strategy. Your solutions are customized keeping in mind your specific requirements and limitations. The consistent use of evidence-based practice helps you avoid commercial gimmicks that advocate losing few inches and kilos of weight in three days, using entirely useless devices that promise to melt fat in hours.

If you are severely obese, BMI will offer you the state-of-the-art surgical procedure that will ensure permanent fat loss and even resolution of diabetes, high blood pressure, sleep apnoea, etc. The icing on the cake is that all the facilities are under the same roof, and at very reasonable cost, too.

IS OBESITY SURGERY FOR ME?

If one has a BMI (body mass index) – calculated as weight (in kgs)Jheight (m2) – of 40 or more. OR a HMI of 35+ two co-tisorbid conditions like diabeevhypertetision. one is a candidate for bariatric surgery. Many obese people have already lost time and money by trying many popular get-slim-quick methods. They arc ready for surgery because they are aware of the real world hard truth – bariatric surgery is the only scientifically proven method of achieving sustained weight loss in the morbidly obese individual.

WHICH PROCEDURE IS THE RIGHT ONE FOR ME?

There are many procedures in bariatric surgery. The ones that are more popular arc the Lap Band, the laparoscopic gastric bypass and. more recently, sleeve gastrectomy. The other less popular procedures arc biliopancreatic diversion. duodenal switch. gastricplication. etc.

Most patients desirous of weight loss alone will benefit from the band/sleeve procedures that are both restrictive procedures in the sense they prevent a person from eating more. The former will achieve a weight loss of 40-50% of excess body weight whereas the latter will achieve 60-70% excess body weight loss. The Lap Band. however, mandates more compliance and follow-up and is tuore susceptible to cheating.

Patients who desire more weight loss to the tune of 70-80% excess body weight will require a procedure like gastric bypass. This procedure creates a situation where food intake is restricted because the stomach is now tiny, along with reduced absorption of ingested food, because the small intestine is short-circuited in some specific way designed to create malabsorption. It is offered to patients who understand that it is one of the most proven and effective procedures for weight loss. This however, comes with a price of a little higher risk of leaks and mortality than procedures like the sleeve gastrectomy and the Lap Band.

Gastric bypass is also the procedure of choice for patients having obesity with diabetes because of a more than 80% chance of curing diabetes.

LIFE AFTER BARIATRIC SURGERY?

Life after bariatric surgery is as it should be for any individual who holds health as a priority concern in his or her life.

All post bariatric surgery patients need to know that they will not be able to eat as much they used to because of their smaller stomach size. Their hunger is satisfied while eating much less than before. The usual instructions for a healthy lifestyle-eating correctly (no sweets, colas, fried food) and moving more apply even after surgery.

Patients who undergo gastric bypass have to consume iron. calcium and vitamin B complex regularly and also need to be checked for the same periodically.

Managing life after obesity surgery is for most patients an enjoyable experience as they start reducing cloth sizes, looking good like never before and feeling lighter, filter and healthier.

WILL I BE ABLE TO HAVE A NORMAL SEXUAL AND REPRODUCTIVE LIFE AFTER WEIGHT LOSS SURGERY?

Many obese people have a poor sex life. They may have associated psychological problems and poor social skills. Post- surgery, as the weight starts reducing, the patient gains his or her mobility and the external genitalia may become more visible as the fat in the area starts melting. It has been seen that patients become more sexually active following weight loss surgery. The fertility rates have also been shown to improve significantly following weight loss surgery.

WHAT ARE THE COMPLICATIONS OF SURGERY?

Weight loss surgery is now proven to be very safe, with a complication rate comparable to any other major planned abdominal surgery. Death after bariatric surgery is as likely to happen as after an appendectomy! However. the overall complication rate (not death) is around 2 to 3 percent.

Gastric bypass procedures may lead to iron and vitamin B deficiencies that need replacement regularly. In the immediate post-operative period there are chances of leaks from the suture/staple lines that may need further management. Sleeve gastrectomy is an extremely safe procedure and is strongly recommended for the highest risk category of the super-super- obcsc and those In which the risks of a leak from a gastric bypass are unacceptable.

HOW LONG DO I HAVE TO STAY IN HOSPITAL?

Patients arc kept in hospital for two days or so. They arc encouraged to get out of bed the same evening of surgery, so that blood clots don’t form in their leg veins. They are advised liquid diet for the first couple of weeks after surgery, and then given normal feeds.

ABOUT BMI

BMI is an exclusive, one-of-a-kind weight management concept with unique features that could be your valuable friend in practice.

• BMI consists of two bariatric surgeons with loads of clinical experience tackling all form of obesity, along with a fitness coach with a reputation for results in fitness and fat loss.
• Centrally located at Belle Vue Clinic, Kolkata and available every working day.
• Updated, scientific, interactive website for both patients and doctors. A forum for obesity within the website is on the cards.
• Regular email, phone and SMS support is given to patients.
• Regular feedback will be given to you about progress and subsequent management requirements.
• The surgical team consists of two surgeons who provide round-the-clock supervision, two Registrars, two highly expert anaesthetists and nutritionists, all of whom ensure that the patient gets the best care and outcome before discharge.
• Our technicians and assistants provide patient support at home.
• Very reasonable packages that are suitable for the middle class patient.
• For the patient (whether Indian or foreigner) who is seeking the highest quality of bariatrie care, we provide the latest disposables and equipments, consistent with the standards of the best centers in the world.

BMI is also keen on working on obesity prevention. We are working hard to enable knowledge awareness at the level of the community, schools and the medical community.