How is OBESITY measured?
It is calculated from a simple formula ( Click Here ) of wt/ht2 or (kgs)/ (m)2 which results in a term called the BMI or Body Mass Index. This allows us to appropriately classify the severity of the weight problem.
What are the indications for OBESITY Surgery?
A BMI of 37.5 or greater, with or without any obesity-related illnesses, or a BMI of 32.5 or greater with the associated illnesses (co-morbidities) listed below or as per the clinician if med fails. Most of these co-morbidities are known to reduce the life expectancy of the patient.
Some of the more common Co morbidities are:
Type 2 Diabetes:
People who are obese become resistant to insulin (which regulates blood sugar levels). Over time the constant elevation of the blood sugar affects many organ systems in the body. Resultant damage can include kidney failure, heart disease, blindness, and susceptibility to severe infections.
High blood pressure / Heart disease :
Obesity leads to elevated cholesterol/triglycerides and causes the heart to work under extreme conditions. These can result in inadequate pumping mechanisms or poor oxygen flow leading to heart failure, heart attacks, strokes, again kidney failure and poor circulation in the lower legs.
Additional weight or stress is placed on multiple joints and their support structures. These include the knees, hips, and back causing rapid degeneration leading to pain ,inflammation, and lack of mobility.
Sleep apnea / Respiratory problems:
Fat deposits in the neck which can block the airway causing a person to temporarily stop breathing during sleep, especially when sleeping on their back. This causes disturbed sleep and results in daytime drowsiness, fatigue and headaches.
Gastroesophageal reflux disease (Hiatal hernia and heartburn):
Increased intrabdominal pressure weakens and overloads the valve at the top of the stomach, which then allows stomach acid to escape and irritate the esophagus. Approximately 10-15% of patients with even mild heartburn can develop Barrett's esophagus, which is a pre-malignant change that can progress into esophageal cancer.
Another complication that worsens with obesity and is sometimes mistaken for the Hypoventilation of Obesity - The increased weight of the chest wall dramatically affects the efficiency of breathing thus decreasing the amount of oxygen available to the body.
Obesity can lead to faulty valves in the veins that promote sluggish flow in vessels causing a clot in the lower limbs. The most feared problem is when one of these clots breaks away and floats into the lungs. This is called as Pulmonary Embolus and this can be a life threatening complication.
People who are obese must deal with constant emotional challenges such as low self-esteem, lack of self-confidence, poor self-image due in part to social discrimination. This leads to social isolation.
Obesity wreaks havoc with male and female hormones, disrupting normal cycles and function, and leading to inability, or difficulty to conceive, or even a miscarriage. The commonest associated condition is PCOD (Polycystic Ovarian Disease)
Urinary stress incontinence:
Increased intraabdominal pressure stresses the muscles of the pelvic floor compounding the effects of childbirth, which can lead to improper function of the bladder. This results in leakage of urine when coughing, sneezing or laughing or inability to hold the urine until the patient can reach a toilet.
Morbidly obese individuals often experience menstrual disruptions, such as heavy frequent, irregular or absent periods and increased pain during the cycle.
Some types of cancers are more common in the obese; e.g. ovarian, endometrial and breast in females, gallbladder and prostates in males to name a few.
Almost all the above mentioned Co morbidities are potentially reversed by Bariatric surgery.
What is the role of non-surgical treatment of Morbidly Obese?
Non-Surgical Treatment includes Drugs, Low calorie Diets and Exercise programs. Drugs (Sibutramine,Orlistat) do not have long term significant weight loss, need to be taken for long time and may have significant side effects. Drug effects are temporary as weight is regained on stopping the drug. Low calorie diets and exercise programs again have temporary effects.
Surgical Treatment is the only proven approach to the treatment of Morbid Obesity adjuvant to lifestyle modifications.
Problem of Obesity - causes and seriousness
Obesity or weight gain is a major topic discussed frequently, but most of the times it is a subject of humor. Very few among us know the scientific truth behind obesity.
Very important thing to remember is that obesity or excess body weight is a disease, prevention of which is to be considered seriously.
The reason behind obesity can be explained with a story which tells us one theory of cause of obesity.
In ancient times, availability of food was a very difficult problem for man. To survive in a situation like natural calamity or whenever starvation was unavoidable, nature has given us a reservoir of the energy which is in the form of fat. But now the circumstances are changed. Now a days, food is available much more than required. So the energy stored in the form of fat is not utilized.
Today’s sedentary lifestyle, ultramodern lifestyle, use of vehicles, fast foods, cold drinks and very high caloric but nutritionally deficient diet are the gifts of the modern world which results in excess weight gain or obesity.
Why obesity is to be considered seriously?
Before some years, obesity was considered as a sign of prosperity, but slowly today’s man could understand that it is a sign of lost health, which is a real wealth.
How serious the problem is?
lets find out recent statistics for India!
A study conducted by The University of North Carolina & Carolina Population center on 4032 Indian females revealed that housewives are more prone to Obesity, especially those belonging to affluent families.
A recent study by a pharma company International Day of Evaluation of Abdominal Obesity (IDEA) in around 60 countries concludes that almost 75 per cent Indian women and 58 per cent Indian men suffer from abdominal obesity.
Obesity is A Second most Largest Preventable Cause of Premature Death
Obesity is a condition which highly impairs quality of your life
Obesity will cross the most feared diseases like – AIDS or heart diseases and will be the leading cause of death in the coming 5 to 10 years.
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