Obesity
What is obesity?
It is excess body weight (more so fat percentage), than the ideal body weight for given height. It is calculated in body mass index BMI, which is a ratio of weight in kilograms to square of height in meters. BMI of 18-25 is considered normal. While between 25.1 to 30.0 is excess body weight, more than 30.0 is considered obesity and again it is graded in ascending order of BMI.
Why obesity happens?
It is the amount of calories imbalance, when in long run more calories are consumed than burnt, fat deposition occurs. Approximately 7700 kilocalories make one kilogram of fat in body weight. While it is not only this imbalance, as obesity is now considered multi-factorial and complex chronic disease, there are many other players in the background.
What are the causes of obesity?
- Increased calories intake due to poor diet, compulsive eating, calorie dense food (high in fats and sugars)
- Decreased calorie burning, sedentary life style, slow metabolism
- Certain Medications
- Genetic diseases
- Hormonal conditions
What are treatment options?
- Lifestyle changes
- Dietary changes
- Increasing physical activity in form of aerobics, sports and weight training
- Medications
- Endoscopic procedures like gastric balloon, endoscopic gastroplasty
- Surgery- Laparoscopic or Robotic Sleeve Gastrectomy, Roux-en-Y gastric bypass, OAGB (one anastomosis gastric bypass) or MGB (Minigastric bypass), SADI- single anastomosis duodenal switch, SADI-S- Single anastomosis duodeno–ileal bypass with sleeve gastrectomy, Duodenal switch, Biliopancreatic diversion etc.
Who is candidate for surgery?
As per internationally accepted guidelines, someone who is struggling to lose weight and has failed with other measures or whose BMI is more than 35 without any obesity related problems, or BMI of more than 30 with obesity related problems, should consider surgery.
What are obesity related problems?
- Hypertension
- Diabetes Mellitus
- Obstructive sleep apnea and snoring
- Cardiovascular diseases like coronary artery disease, atherosclerosis, heart failure, stroke
- Depression
- Osteoarthritis
- Infertility
- Increased risk of certain cancers ie. Breast, colon, liver, pancreas
What are types of surgery?
- Restrictive (Sleeve, gastric band)
- Malabsorptive (Biliopancreatic diversion, duodenal switch)
- Mixed (Roux-en-Y gastric bypass, OAGB, SADI)
