What is Obesity?
Obesity is estimated to affect more than 1.7 billion people. Obesity is now called Globesity as it has become a global epidemic
Problem is severe in India too, and is on rise. In India obesity is not looked upon as a serious disease and hence people are not aware that it can be treated medically. India alone accounts for more than 25 million people suffering from morbid obesity. Obesity is on the rise in India especially in the Metros. Obesity is a disease defined aslife-long, progressive, life-threatening, costly, genetically-related, multi-factorial disease of excess fat storage with multiple co-morbidities i.e. associated health problems.
In last few decades a major change in lifestyle resulted from the advances in science. This progress in science is mostly used in making our life style more and more inactive-Increasing use of remote controls and usage of vehicles is called as modernization . In addition to that, a change in today’s food in mostly in the form of having calorie dense meals with very low nutritive value is the contributory factor. This is the major cause of energy imbalance in our body.
Sedentary life and high calorie low nutritional value food are the indicators of modernization and an average person relates that to the progress in life as well as happiness.
But, the causes of severe obesity are multi factorial and the patho physiology of morbid obesity syndrome is complex and serious medical disorder.
We should change the lookout for an obese person as a subject of humor. Now it is a time to understand that obesity is a disease – a medical condition which is a result of some more factors than excess eating or lack of exercise We must get a help of medical science in treating obesity We can achieve a weight loss with maintaining health – or rather improvement of overall fitness of a person if are taking a help of a qualified medical professional with enough experience in that field.
Dr. Shashank Shah’s Laparo-obeso Centre is one of the most experienced comprehensive team of experts in the field of treatments of obesity and metabolic disorders. Dr. Shashank Shah, is an eminent laparoscopic and bariatric surgeon of International repute.
Dr. Poonam Shah, a bariatric physician and other consultants are also medical experts in the team
In Asian continent , there us a genetic predisposition of high body fat content at lower body weight Higher insulin resistance and higher deposition of fat in central region of the body i.e. central obesity are also the specific additional constitutional risk factors in Asians A pecularity of Asians is higher risk of diseases like type 2 diabetes and other metabolic disorders at comparatively lower body weight and lower age than Caucasians This makes Indians more vulnerable to Obesity and its related diseases.
How Obesity affects life
Obesity is a disease which always comes with associated major health problems like type 2 diabetes, high blood pressure, gall stones, high level of blood cholesterol, early heart diseases, acidity, joint pain, etc.
The problems resulting from obesity like-polycystic ovarian disease can result to infertility. Similarly, infertility and even sexual dysfunctions can be present in association with high body weight in male as well.
Problem of obesity can turn out to be fatal by developing ischaemic heart disease, benign intracranial hypertension , pulmonary embolism , sleep apnoea or even some types of cancer.
Other than above mentioned medical diseases related to body of the person there are many other disorders of mind of an obese person .
Social discrimination and psychological impairment are the obvious but somewhat neglected issues of an obese person, which can grossly affect the carrier of a person or can ruin the family life or emotional relationships in family or friends.
All these problems are giving the significant negative impact on the quality of life of an obese person.
About heart risk with Obesity
- South Asians around the globe have highest rate of cardio vascular disease (heart attack with high death rate). There would be 62 millions patients of CVD in India by 2015 and out of these 23 million would be patients lesser than 40 yrs of age.
- An estimated loss of 9.2 millions productive years of life in 2000 and expected to rise to 17.9 million years in 2030. (: NCMH i.e. National committee on macronutrients and health ,a government of India undertaking)
This is significantly higher than rest of the world.
Treatment options for weight loss
Even a small weight loss is giving a boost to the self confidence & self esteem with resultant improvement the quality of life of the person & the family.
A preventive measure is really important for avoiding disease like obesity Obesity is the second most preventable cause of premature death So we should be serious about attempting healthy weight and fitness. As mention earlier, our concept of relation of progress and unhealthy lifestyle needs to be changed. Concept of celebration of anything like festivals or anyone’s success should not only be with consumption of sweets or other high calorie food or even alcohol. This change must be started with very early age. Rather prevention of childhood obesity is not only the responsibility of the parents, but whole society including schools must plan for the same aggressively . This will significantly improve the future of the nation. An earlier detection of the problem is required.
Considering the treatments for weight loss, lifestyle modification is always of prime importance as that is the main causative factor of obesity. A properly designed diet with some physical exercise is helpful when a person is overweight.
A medical intervention is needed in the management of weight loss. But very few drugs are available in the market which are relatively safe and scientifically approved
The published success rate for all medical approaches, including pharmacotherapy and behavioral modification, especially for morbid obesity is extremely poor. An estimated 95% of morbidly obese patients subjected to medical weight-reduction programs regain all of their lost weight, as well as additional excess weight, within 2 years of the onset of therapy. Because of the extremely high failure rate of all non surgical attempts to correct morbid obesity, including diet, behavior modification, hypnosis, voluntary incarceration and intragastric balloons, the presence of morbid obesity itself is an indication for surgical correction withy the help of a procedure called as bariatric surgery.
What is Bariatric surgery?
The issues of problems of obesity is fortunately having a lifetime and scientific solution like bariatric surgery. An obese person when undergoes bariatric surgery with an expert surgeon and follows recommended changes in lifestyle, can loose all excess weight. But the main thing about this treatment option is that patient can get rid of all associated problems with obesity in a very short period after the surgery, long before the significant weight loss happens. An important example of this is the resolution of type 2 diabetes in such patient only in few days
after bariatric surgery. Such improvement is seen in all other obesity related health issues Weight loss surgeries are now more safe and acceptable as they are done by laparoscopic techniques.-a key hole technique. This technique offers quick recovery with minimum or no weight loss.
The procedures are few types
- In one type, called restrictive operations, the size of the stomach is reduced. The person undergoing this procedure feels full after consuming a small quantity of food. This restricted diet along with moderate exercise results in steady weight loss. The Adjustable Gastric Band and the Sleeve Gastrectomy are restrictive procedures and are done laparoscopically. A credit of initiating a relatively less invasive procedure like sleeve gastrectomy in Asia goes to Dr. Shashank Shah This procedure is proven as the best suitable procedure in a population which is mostly non vegetarian.
- The second type, represented by the Gastric Bypass operation, works by both restriction and malabsorption of food. This procedure is also done laparoscopically, and a small stomach pouch is created. Eating a small quantity of food results in a feeling of fullness, and only part of the food that is consumed is digested.
In Laparo-obeso Centre, a new innovative technique is used called as single incision laparoscopic surgery , in which the above mentioned surgeries are done through a single incision made near umbilicus in such a way that the scar after the surgery is almost invisible. This superspecialised technique is demonstrated in the international conference for the first time in Asia by Dr. Shashank Shah and his expert surgical team.
Effects of weight loss surgery
Bariatric surgery was initiated for its effect on obesity. However over years its metabolic effects, especially the improvement in Type 2 diabetes revolutionized its application.
A patient should choose a surgeon who is having a multidisciplinary team of experts who is well trained about the preoperative assessment and post operative follow ups of bariatric patients.( Our centre is the only centre in Asia who is having such well trained and dedicated team )
Changes in the body composition correlate with changes in risk parameters of the patient.
Previous American and European studies showed the significant impact of bariatric surgery on CVD risk reduction. NO study exists as on today which evaluates whether these operations /treatments help in any risk reduction in Indian population and what is their impact on the long term outcomes of the patients.
The aim of bariatric surgery is the restoration of the normal metabolism of the dysmetabolic in addition to weight loss.-is shown by the study conducted by our unit i.e. Laparo-Obeso Centre IN 2008 AND 2009. We evaluated the impact of bariatric procedures on predicted risks of cardiac events. We used the Framingham risk engine tool to predict the % of risk among patient having before and after treatment.
Framingham risk score predicts 10 years absolute risk of Coronary heart disease.
Our findings suggest that bariatric surgery is associated with reduction in cardio vascular disease risks.