Bariatric Surgery
People who have struggled for many years with the illnesses and discomforts related to severe obesity often give up hope. They know what it is like to persevere time and again with diets and programs that fail to deliver long-term results. Nonetheless, giving up is not an option. Their lives depend on successfully treating obesity and maintaining a healthy weight throughout life. If you are someone for whom non-surgical procedures have failed to provide sustained weight loss, you can be evaluated for, and if appropriate, undergo lifesaving bariatric surgery. In cases of severe obesity, bariatric surgery is the only proven method of achieving long-term weight control.
Our multidisciplinary team of bariatric experts will see you through the entire process. We will make certain that you are prepared for surgery, both physically and psychologically, and we will provide the most advanced and current procedures that are right for you. After surgery, we will assist you in committing to the lifestyle changes that will assure optimal success.
What is Obesity and the related health problems?
Obesity is a life-long, progressive, life-threatening condition marked by excess body fat, which can significantly reduce life expectancy. When weight increases to an extreme level, it is called morbid obesity, and is a chronic condition with numerous medical, psychological, social and economic consequences.
The more obese you are, the more likely you are to have health problems. You are more likely to develop health problems; such as,
- Heart disease
- Diabetes
- Hypertension
- sleep apnea (interrupted breathing during sleep)
- osteoarthritis (wearing away of the joints)
- Menstural irregularity
- Stress incontinence
- Cancer (such as colon cancer, endometrial cancer, and postmenopausal breast cancer)
- Gallbladder disease
- Stroke
- Sudden death.
How do you measure the degree of obesity?
Weight is commonly measured in Kilograms. The degree of obesity is better measured as BMI (body mass index) which is a ratio of weight and height [Wt in Kg / (Ht in metres)2]. Obesity can be graded as:
BMI Calculator
| Degree of Obesity | Body Mass Index | |
|---|---|---|
| For Westerners | For Indians | |
| Overweight | 25.0-29.9 | 22.5 – 27.5 |
| Obesity | 30-34.9 | 27.5 – 32.5 |
| Severe obesity | 35-39.9 | 32.5 – 37.5 |
| Morbid obesity | 40-49.9 | 37.5 – 47.5 |
| Superobesity | >50 | >47.5 |
What is the medical treatment of Obesity?
Adequate diet and exercise are the key components. A recommended balanced diet should provide 1200-2000 Calories a day depending upon the person’s lifestyle. A diet restriction of 500Cal/day is expected to cause a wt loss of approx 1lb/week. A regular exercise pattern is of immense importance. A duration of 30-45 minutes per day, at least 3-5 days/week is recommended by most. Even if you are planning for surgery, an exercise plan is a must.
Medicines for obesity have come and gone because of their undesired effects. At present, the only FDA approved drug is Orlistat. Even this is not free of side effects and causes only upto 10% weight loss in six months, most of which is regained after stopping the drug.
What is the need to undergo surgical treatment of obesity?
Various studies all over the world have proved that surgery is the most desirable and durable treatment option for morbid obesity. With the current surgical procedures, a loss of 68-78% excess body weight is lost. The most dramatic loss is in the first six months. The procedures like Roux-en-Y Gastric Bypass and Sleeve gastrectomy reduce food intake because of early filling as well as decreased hunger. This avoids ‘starvation’ to get slimmer.
Does Obesity Surgery resolve diseases like diabetes, hypertension, sleep apnoea etc.?
Yes. Bariatric Surgery has shown to cure diabetes in 83% of patients and reduce the dose of Insulin & OHA in 17%. The control of hypertension also becomes better. Obstructive sleep apnoea patients show a remarkable improvement.
In our own analysis of > 200 patients who underwent Laparoscopic Sleeve Gastrectomy at Institute of Minimal Access, Metabolic & Bariatric Surgery, Sir Ganga Ram Hospital, there was a resolution of Diabetes in 79% patients, resolution of hypertension in 63% patients and improvement in Obstructive Sleep Apnea in 93% patients.
Am I a candidate for surgical treatment for obesity?
If you are an Indian/Asian and have BMI of 37.5 or more, you are a candidate for Bariatric Surgery, as it is the only durable option at this stage.
If you have Hypertension / Diabetes / Obstructive Sleep Apnea / Osteoarthritis knee or have any other obesity-related diseases, surgery is recommended at a BMI of 32.5 or more.
It is a serious undertaking, not a cosmetic procedure. Anyone thinking about undergoing this type of operation should understand that the surgery will cause a reduction in the number of calories you may consume, and you must commit to lifestyle and dietary changes to derive maximum benefit from the procedure. The surgery in not a cure-it is only a tool. Success is possible only with your full cooperation and commitment to behavioral change and medical follow-up, which must be carried out for the rest of your life.
How Does Bariatric Surgery Work?
Bariatric surgery promotes weight loss by restricting food intake and, in some procedures, altering the digestive process. As with other treatments for obesity, the best results are achieved when combined with healthy eating behaviors and regular physical activity.
If bariatric surgery is the right choice for you, your surgeon will discuss with you the different procedures and will explain which would achieve the best outcomes for your individual circumstance.
