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The excessive accumulation of fat that exceeds the bodys skeletal and physical standards The National Institute of Health (NIH) states that excessive weight becomes a health hazard when it is 20 percent or more above ideal body weight Patient with serious health risk are susceptible to serious diseases like heart disease, respiratory diseases or even infertility. It can result in either significant physical disability or even death.
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Obesity can be caused due to various reasons like changed lifestyles, energy dense diets, low level of physical activity, environmental factors, heredity, psychological and cultural influences and many others Heredity: Genes may increase vulnerability to obesity Metabolic Factors Endocrinological factors: This is a rare occurrence and contributes to less than 1% of all weight gain in the world. Hypothyroidism: Hypogonadism in men and Polycystic Ovarian Syndrome in women are closely associated with obesity Medication: Certain drugs may contribute to weight gain, such as corticosteroids, sulfonylureas for diabetes, steroidal contraceptives and anticonvulsants such as valproate used in epileptic therapy. Antipsychotics, antidepressants, mood stabilizers like lithium are medicines that have weight gain as a side effect. Psychological Factors: Though psychological factors play a minor role in the development of obesity, they are important in relation to responses to treatment. For example, many patients reduce depressive symptoms by eating. These people may gain weight with one episode of depression and increase it with the next. Further, concepts of dietary restraints, body image dissatisfaction and binge eating disorders have been intimately linked to the increase in obesity Dietary Factors: An increase in caloric intake, changes in lifestyle, food systems and increased portion sizes, eating out frequently also leads to increased calorie intakes as one meal served in restaurants and fast food outlets exceeds a persons caloric needs for the entire day.
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Mortality: Research shows that excessive body weight is linked to overall health and susceptibility to chronic ailments. It has been proven that a BMI beyond 30 kg/m2, increases the risk of cardiovascular death, heart attack and diabetes, even after adjusting for age, smoking, social class, alcohol consumption and physical activity. Studies show that non smoking overweight men and women lose 3.1 and 3.3 years of life respectively compared to normal weight non smokers. These studies have also established that weight fluctuations increase the risk of death. Coronary heart disease is the major cause of weight-related death followed by diabetes mellitus, digestive diseases and cancer. Evidence suggests that women can reduce mortality rate by 25% in diabetic, cardiovascular and cancer conditions by achieving a weight loss of 9 kgs. However if an obese person has already developed an associated co-morbidity, then planned weight loss of any amount has been reported to reduce mortality by 20%. It has also been established the risk of mortality is greater in younger patients suffering from obesity as compared to older ones. Morbidity: Obesity is associated with chronic diseases such as heart disease, Type 2 diabetes, hypertension, stroke, gallbladder disease, sleep apnea, certain cancers and osteoarthritis. These chronic ailments tend to worsen with increasing degree of obesity. Nonalcoholic fatty liver disease which may progress to end-stage liver disease is now also being recognized as a consequence of obesity. Obesity may also lead to poor wound healing and poor antibody response. Regional Distribution of fat & Health Risk: There are two type of Obesity 1. Android or apple-shape obesity 2.Gynoid or pear-shape obesity This fat distribution is determined genetically and varies among men and women. Android obesity is more common among males whereas females are more susceptible to gynoid obesity. While incase of gynoid obesity it is more difficult to shed weight, the android obesity is linked to chronic ailments such as glucose intolerance, insulin resistance, hyperlipidemia and hypertension. This type of obesity is also closely associated with the development of metabolic syndrome (a complex of unified conditions like glucose intolerance, high blood pressure and alterations in serum lipids).
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Mortality: Research shows that excessive body weight is linked to overall health and susceptibility to chronic ailments. It has been proven that a BMI beyond 30 kg/m2, increases the risk of cardiovascular death, heart attack and diabetes, even after adjusting for age, smoking, social class, alcohol consumption and physical activity. Studies show that non smoking overweight men and women lose 3.1 and 3.3 years of life respectively compared to normal weight non smokers. These studies have also established that weight fluctuations increase the risk of death. Coronary heart disease is the major cause of weight-related death followed by diabetes mellitus, digestive diseases and cancer. Evidence suggests that women can reduce mortality rate by 25% in diabetic, cardiovascular and cancer conditions by achieving a weight loss of 9 kgs. However if an obese person has already developed an associated co-morbidity, then planned weight loss of any amount has been reported to reduce mortality by 20%. It has also been established the risk of mortality is greater in younger patients suffering from obesity as compared to older ones. Morbidity: Obesity is associated with chronic diseases such as heart disease, Type 2 diabetes, hypertension, stroke, gallbladder disease, sleep apnea, certain cancers and osteoarthritis. These chronic ailments tend to worsen with increasing degree of obesity. Nonalcoholic fatty liver disease which may progress to end-stage liver disease is now also being recognized as a consequence of obesity. Obesity may also lead to poor wound healing and poor antibody response. Regional Distribution of fat & Health Risk: There are two type of Obesity 1. Android or apple-shape obesity 2.Gynoid or pear-shape obesity This fat distribution is determined genetically and varies among men and women. Android obesity is more common among males whereas females are more susceptible to gynoid obesity. While incase of gynoid obesity it is more difficult to shed weight, the android obesity is linked to chronic ailments such as glucose intolerance, insulin resistance, hyperlipidemia and hypertension. This type of obesity is also closely associated with the development of metabolic syndrome (a complex of unified conditions like glucose intolerance, high blood pressure and alterations in serum lipids).
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Obesity can be caused due to various reasons like changed lifestyles, energy dense diets, low level of physical activity, environmental factors, heredity, psychological and cultural influences and many others Dr. Sinha has been invited faculty as speakers and for live demonstrations of the advanced laparoscopic and bariatric operations at various national conferences. Minimally invasive or key hole surgery technique. Type of bariatric / metabolic surgery is decided according to the need and compliance of the patient. The only team in Asia pacific region having a multidisciplinary team of experts devoted for patient care. Very high success rates and low complication and mortality rates. Thorough preoperative preparation program to improve safety of the procedure. Easy access to medical specialties, availability of team doctors 24/7 for urgent problems. Intensive follow-ups by the team which helps patient to succeed. A centre easily accessible as it is placed in metro city Mumbai.
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Obesity and it treatment requires tremendous support. Unlike what most people think, obesity is not caused by over-eating or eating disorders. It is a chronic disease, the causes of which may vary. People suffering from obesity may suffer from severe depression as well and need tremendous support from their loved ones. What one needs to understand is that the first step towards any kind of remedy is fraught with many unexpressed fears and tensions the support of friends and family is of incalculable help at such times.
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Cardiovascular Essential hypertension Myocardial infarction, hypertension and congestive heart failure Fatal or non-fatal myocardial infarction Risk of coronary heart disease With every 1 kg of weight loss, there is a corresponding reduction by about 1% in total cholesterol and LDL and a rise by 1% in HDL and a 3% decrease in triglycerides. Metabolic Syndrome Central adiposity is also more closely associated with the development of metabolic syndrome than the absolute degree of fatness. Prevalence of diabetes mellitus and cardiovascular disease. Pulmonary Obesity hypoventilation syndrome (OHS) Obstructive sleep apnea syndrome (SAS) Digestive Diseases Fatty infiltration Cancer Colorectal cancer Endometrial cancer Childhood Obesity
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Generally accepted guidelines from the American Society for Bariatric Surgery and the National Institutes of Health indicate surgery only for those 18 years of age and older. Surgery has been performed on patients in their teens. There is a real concern that young patients may not have reached full developmental or emotional maturity to make this type of decision. It is important that young weight loss surgery patients have a full understanding of the lifelong commitment to the altered eating and lifestyle changes necessary for success.
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For Patients over 65 years of age need to evaluate the fitness of the patient to undergo surgery.
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Yes
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At one year after successful bariatric surgery, 96% of obesity related medical conditions are either completely resolved or significantly improved.
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Certain basic tests are done prior to surgery: a Complete Blood Count (CBC), a complete profile in terms of liver functions, kidney functions and lipid profile will be done, Thyroid Function Test, Iron levels, B12 levels. All patients but the very young get a chest X-ray and an electrocardiogram. Due to the high incidence of obstructive sleep apnea, most patients will require a polysomnography study. Patients will get an abdominal ultrasound. Other tests, such as pulmonary function testing, echocardiogram, GI evaluation, cardiology evaluation, or psychiatric evaluation, will be requested when indicated.
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An accurate assessment of your health is needed before surgery. The best way to avoid complications is to never have them in the first place. If you are diabetic, special steps must be taken to control your blood sugar. Our objective is to maximize your likelihood of success.
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Patients, who have significant gastrointestinal symptoms such as upper abdominal pain, heartburn, belching sour fluid, etc., may have underlying problems such as a hiatas hernia, gastroesophageal reflux or peptic ulcer.
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The sleep study detects a tendency for abnormal stopping of breathing, usually associated with airway blockage when the muscles relax during sleep. This condition is associated with a high mortality rate and can be present in nearly 70% of obese patients. It is important to have a clear picture of what to expect and how to handle it.
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Bariatric surgery will require significant changes in your lifestyle and will also change your life. A psychiatric evaluation will help prepare you for these changes by developing coping skills and encouraging behavior modification. Additionally, our psychiatrists will evaluate your understanding and knowledge of the risks and complications associated with weight loss surgery and your ability to follow the basic recovery plan.
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Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, if they are problems that are related to the patients weight, they also increase the need for surgery. Severe medical problems may not dissuade the doctor from recommending gastric bypass surgery if it is appropriate, but those conditions will make a patients risk higher than average.
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No. Laparoscopic operations carry the same risk as the procedure performed as an open operation. The benefits of laparoscopy are typically less discomfort, shorter hospital stay, decreased hernia and wound infection rates, earlier return to work and reduced scarring.
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Every attempt is made to control pain after surgery to make it possible for you to move about quickly and become active. This helps avoid problems and speeds recovery. Often several drugs are used together to help manage your post-surgery pain. While you are still in the hospital, a Patient Controlled Analgesia (PCA), which allows you to give yourself an intravenous dose of pain medicine on demand, will be used to initially control your pain. When you are ready to go home, you will be given a prescription for pain medicine.
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As long as it takes to be self-sufficient. Although it can vary, the hospital stay (including the day of surgery) can be 1-2 days for a laparoscopic band, 3-4 days for a laparoscopic gastric bypass.
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Almost immediately after, the doctor will require you to get up and move about. Patients are asked to walk or stand at the bedside on the night of surgery, take several walks down the halls the next day and thereafter. Walking is the most effective means to decrease your risk of having a pulmonary embolus. On leaving the hospital, you may be able to care for all your personal needs, but will need help with shopping, lifting and with transportation.
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For your own safety, you should not drive until you have stopped taking narcotic medications and can move quickly and alertly to stop your car, especially in an emergency. Usually this takes 3-5 days after surgery.
