OBECON

Obesity FAQ’s


Determining whether someone is overweight or obese is often determined by assessing a person's body mass index (BMI), which is a ratio between weight and height. If your BMI falls between 25 and 29.9, you are overweight. If your BMI is 30 or higher, you are considered obese

However, you may have an excess fat percentage in your body even though the total weight looks less. If this excess fat is causing diseases like diabetes, hypertension, psychological discomfort and resistant to medical treatment, you may be a candidate for metabolic treatment

Being obese puts you at risk for a number of preventable diseases and conditions, including heart disease, type 2 diabetes, high blood pressure, stroke, gallbladder disease, breathing problems, certain types of cancer, chronic back pain, osteoarthritis, infertility, PCOS, psycho-social challenges. Obesity may also take a toll on self-esteem and contribute to depression. On a positive note, there are various proven treatments available for treating obesity.

You may be advised by your doctor to consider weight loss surgery if your body mass index (BMI) is 25 or higher and you are facing trouble with comorbidities, or in case your BMI is 30 or higher with no risk factors. Your medical history and your attempts to lose weight will also be considered.

No, the Liposuction is a cosmetic procedure for the re-sculpting small amount of unwanted body fat. Liposuction is not a weight-loss operation. Whereas bariatric surgery is an operation that reduces caloric intake and the way fat is deposited. Bariatric surgery can achieve a sustained and lasting weight loss for the treatment of morbid obesity.

Bariatric and metabolic surgery treat the root cause of the formation of fat and its deposition. Whereas liposuction only removes fat under the skin temporarily, subsequently fat can get deposited in the same or other areas. The fat deposition also exits inside the organs mainly like the abdomen, fatty liver, fatty pancreas, etc. Fat inside the organ is the main cause of various diseases

Weight loss surgeries are known as metabolic surgery since it changes the disease metabolism of obesity. These surgeries induce various hormonal changes that reduce excessive cravings and improve the satisfaction of eating; thereby reducing the overall intake of food. Certain malabsorptive procedures like gastric bypass prevent absorption of fat consumed. The hormonal changes increase the BMR of the patient and all the fat deposited slowly gets converted into energy and melts and disappears. It is actually a myth that patients cannot eat after bariatric surgery.

The person loses 8-20kgs in the 1st month and 4-10 kgs/ a month, thereafter depending on initial weight. Weight loss continues for 1 1/2 to 2 years till one reaches near-ideal weight and slows down gradually. The results of each individual are different and may not be compared.

All the 7,000 plus patients treated over 16 years seem to be happy with the overall results. The main goal of the treatment is to resolve the diseases and improve the quality of life.

With the present advances in therapy, the bariatric procedures can almost be daycare procedures.
However, 1-2 days of stay is most comfortable for most of the patients. Being a keyhole with no scar and painless surgery, patients start moving about in about 2 hrs after surgery and start drinking fluids 4 hrs post-operatively.

Special arrangements have been done for those who are oversea as to stay in the hospital for 3-5 days wherein they save the hotel costs and use the last few days for sightseeing and enjoyment.

There are no major side effects of surgery, just your whole lifestyle changes. It enhances your health & makes you more active and energetic in your daily routine. You will find yourself see health improvement post-surgery.

You will have to follow a liquid diet only for a week to 10 days after surgery. And then you can start with soft and pureed food and slowly switch to a normal routine by the end of a month. Just you need to eat how much your stomach demands. Our team will guide you through this journey and the guidance could be over the phone, email, Whatsapp, Skype or a video call, etc.

The female patients are advised to wait at least for a year after surgery to avoid the stress of a pregnancy during the period of rapid weight loss and allow her weight to stabilize. Usually, the possibility of getting pregnant increases after weight loss. You are advised to use contraceptive methods for the first 12 months. Thereafter pregnancy is safer as blood pressure, blood sugar levels become normal & the baby weight also is normal.

Bariatric surgery works on the principle of satiety. Though your hunger will be normal, you will feel satisfied/satiated with a small amount of food. Even today you eat till you are full. After surgery, you will be able to eat until you are full (with a smaller amount of food).

Proper diet and exercise do work, especially when started at a young age and continued faithfully throughout your life. Unfortunately, for people who are already struggling with obesity, the cards are stacked against them. Diet and exercise work more for prevention or during early treatment of obesity.

However, if the body physiology is trying to get your weight back, your attempts to lose weight succeed only temporarily. Once a person's BMI crosses a certain limit, say above 30 kg/m2, the metabolism changes to that of weight regain. Hence, it is not easy to lose weight with diet and exercise if you have severe obesity.

We provide patients with care that they deserve and need. The main priority at LOC is patient safety and wellbeing. LOC has highly experienced surgeons and bariatric staff and have treated more than 7,000 patients to date.

Yes we have EMI options from leading banks for further details contact us ( give contact us link )

The Asian guidelines for overweight or obesity are different from European and American guidelines as Indians have a higher fat percentage as compared to their European and American counterparts.
Being overweight or obese can be calculated by either method of BMI calculation, Waist Circumference, or a more advanced method of Body Fat Percentage with the help of Body composition.
BMI is calculated by kg/m2, where a person's weight in kilograms and m2 is their height in metres squared. A Normal BMI lies in the range 18-22.9kg/m2, BMI between the range 23-24.9kg/m2 is defined as Overweight, BMI >=25kg/m2 is defined as Obese and any BMI 32.5kg/m2 is defined as Morbidly Obese.
A Waist Circumference >80cms in Females and >90cms in Males is an indication of Obesity
Similarly, any person with a Body Fat Percentage of >20% is defined as Obese and a person with a Body Fat Percentage of >30% is defined as Morbidly Obese
If a person falls under any of the above categories of BMI, Waist Circumference or Body Fat Percentage they are defined as overweight or obese.

Obesity can put a person at a risk of various preventable health conditions like Type II Diabetes, Heart Disease, Hypertension, Sleep Apnoea, Joint Pain, Osteoarthritis, Polycystic Ovarian Disease (PCOD), Infertility, Sexual Dysfunction, Fatty Liver, Breathlessness, Urine Incontinence, Reflux Disease, Depression, Lack Of Self-Esteem Or Confidence And Any Other Psycho-Social Challenges which can affect Quality Of Life.

The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. A weight management program combines physical activity, diet, behavioral modification, psychological counseling, and sometimes drug therapy to help patients achieve weight loss or prevent further weight gain. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity

Bariatric Surgery is a keyhole procedure on the stomach and/or intestine which changes the metabolism favorably and improves hormonal imbalance. It induces weight loss to almost 80% of the original weight and reverses many obesity-associated health problems.
Liposuction is a procedure to remove fat under the skin using a suction device. It is not known as a weight loss procedure. Liposuction can change body contour and can offer cosmetic benefits. However, it is contraindicated patients with Morbid Obesity or in patients with a high BMI.
Fat inside the abdomen, especially around the liver, intestines, and viscera secrete various hormones which are responsible for various metabolic disorders like diabetes, heart disease, kidney disease, fatty liver disease etc which could be life-threatening. Bariatric Surgery is known to dissolve this fat, have it converted into energy and reverse many of these health-related conditions. Liposuction has no impact on the fat inside the organs and hence cannot contribute to better health benefits even though it can offer cosmetic benefits.

Hypertension or high blood pressure occurs when the force with which the blood pushing against the artery wall is too high. Any blood pressure above a mark of 140/90 is called blood pressure and above 180/120 is called severe. The significant rise in obesity is found to have a direct correlation to risk of high blood pressure. Obesity and hypertension together can give rise to an array of health issues and challenges there by affecting health, quality of life and life expectancy. Apart from just weight and obesity the fat distribution is also an important factor that plays a major role. Abdominal Obesity or central obesity around the waist circumference is the influencing factor for developing hypertension.

A BMI above 30 is a major risk factor for high blood pressure. When a person is overweight or obese, the heart has to work harder to pump blood throughout the body. This puts an excess stress on the arteries which in turn makes the arteries to resist this flow causing the blood pressure to rise.

Obesity is now defined as a “chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.” Obesity is not just a cosmetic concern anymore It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers. The WHO, all Indian as well as International health organizations have declared obesity as a disease.

How does obesity induce sexual dysfunction in males and females?
Obesity can induce sexual dysfunction in a male or female due to various reasons. Some of most simple reasons are: severe joint pain, breathlessness on lying down, backache, in males, in-drawing of the genital organs due to excess fat deposition as well as diabetes, high blood pressure, snoring etc all of which further reduce sexual functioning. Obesity also induces certain hormonal changes because of which sexual libido are suppressed. Poor confidence, body image issues and poor self esteem as well as depression can aggravate these further.
How does obesity induce sexual dysfunction in a female?
Fat is known as an endocrine organ and in a female with obesity it can convert female hormone into male hormone (androgenic environment). This can be seen as excess hair growth on the face, pimples, or black discoloration which continues to increase. At the same time excess belly fat or excess fat deposition can have in drawing of the genital organs, bodily pain, back ache can aggravate this and most importantly snoring diabetes and the excess male hormone generated by fat reduce sexual drive, libido reduce her confidence, lead to body image issues in a female and can disturb the quality of sexual life.
How does obesity reduce sexual function or fertility in a male?
Fat in a person with obesity can reduce the testosterone or male hormone levels in a male. Reduction in testosterone can reduce desire for sexual function. Excess fat can give rise to what is called pseudo hypogonadism or in drawing of the genital organ because of excess fat. Even the temperature change in the scrotum can reduce the quality of sperm and reproduction of sperm thereby reducing fertility in a male thus sexual dysfunction is seen both in males and females which is not commonly known to most people

Type II diabetes is a complex disorder. Many factors responsible are: genetic tendancy, pancreatic function, sesitivity of muscles to insulin, fat stores in the liver as well as grade of activity and lifestyle. Even though, some patients with morbid obesity do not have diabetes, their pancreas secretes higher level of insulin due to the insulin resistance. Insulin resistance varies from person to person. Hence everyone with morbid obesity does not necessarily get diabetes but may have pre diabetes or weight related co-morbidities and fatty liver disease. At the same time some people woth lesser grade of obesity maty have diabetes. thorough investigations to know the type of diabetes, pancreatic function are necessary since there are many genetic variants of diabetes which appear like type 2 diabetes but they are not.

The patients with morbid obeisty has tendency for deep vein thrombosis. That is why those who have varicose veins, ulcers on legs , those who are extermely overweight or those with extremely high BMI,they are instructed to keep hydration well, use stockings and in selected cases they are advised to take blood thinners for 2-3 weeks based on risk of deep vein thrombosis.

Any weight loss induced by medicines, diet, any illness or after surgery can innduce some hair fall.This hair fall can be prevented by vitamins , minerals, protein supplements, biotin , adequate hydration, adequate fibre intake . adequate iron intake under the supervision of qualified baritric expert and nutritionist. There is nothing to worry as hairfall is temporary and not the hair loss.

This has been attempted by researchers, scientists and many people to follow a low calorie diet for long term. However once you start low calorie diet and amount body's hormones start stimulating your hunger ,start reducing your metabolism,following which replase of weight happens.It is not easy for anyone to follow this diet lifelong , however after the gastric bypass because the hormones are altered , changed the meatbolism is corrected as well as the hunger , cravings are reduced it is easier for the pateint to follow the diets after surgery because the operations mechanism works on the centre in the brain and hence this can be achieved by the patients.

Gastric bypass surgeries are the malabsorbtive procedures.Hence the patients are advised to consume nutrient dense foods rather than calories dense foods.Fresh foods , salads, fruits rich in vitamins and minerals, protein rich diets like pulses, lgumes, eggs , soyys, chicken can be consumed. How ever these are just the broad guiedlies one shoild consult a bariatric nutritionist for a personalised diet as per the body requirements.

There is actually nothing that one cannot do after baritaric surgery . Infact you lose weight , your illness get treated , your self esteem improves and you can practically resume normal life after gastric bypass surgery. What should not be done is absue of anthying which is high in calorie or addictions.

Diet post bariatric surgery is as per the American guidelines for surgery. The diet varies from clear liquids for the first 10 days to thicker, pureed food and then soft to normal diet over a period of one to two months. The diet though standardised, the dietary options are specific to each country, state and dietary habits. Generally the suture line takes about 6-8 weeks to heal, in that period the dietary phases of a person change and move to the next phase.

Some of the scientific ways of losing weight are lifestyle modifications ie., diet and exercise, pharmacotherapy and endoscopic, weightloss procedure. The most amount of weight one loses depends on the age, height, weight, BMI, health problems occuring with obesity and the right approach at the right time.

There are different approaches for weight loss like diets, physical activity, pharmacotherapy, Endoscopic treatment, weight loss surgeries. Generally, the first line of treatment though is diet and exercise, whether it will work for a patient or not depends on the right approach at right time depending upon age, height, weight, BMI and co morbidities, past attempts of weight loss. Weight loss pills can be effective if combined with diet and exercise and are generally given to someone who ranges between the BMI 25-28kg/m. Any BMI higher than that, the metabolism changes and the person is unable to lose weight or maintain the lost weight with the modality of weight loss pills. In such patients the weightloss pills prove to be ineffective. Hence the treatemnt that one attepmts to follow should be adviced by an experienced team of experts who have adviced such treatments.

Yes, one can eat the night before a gastric sleeve, ideally before a bowel cleanser is given to the patient.

Any bariatric surgery can be done almost like a day-care procedure. The patient ideally walks to the Operation Theatre and walks back to the room post surgery. Recovery period could be about a few hours and a person can get back to a normal routine is a day or two.

The type of procedure anyone undergoes depends on the paetiens age, BMI, Co- morbidities occuring with obesity, the type of food and lifestyle a patient follows. For a person who weighs 545lbs, all types of surgery can be performed based on the clinical opinion from the surgeon and a detailed consultation with the patient.

The scientific way of losing weight is by restricting diet, improving physical activity, adding some treatment like medications. Generally this kind of weight is lost in very huge patients where excess weightloss is very high only after Bariatric Surgery. The treatment has to be based on a person's BMI, total excess weight, lifestyle, genetics and an ideal obesity centre should design the weightloss treatment for the patient.

There are different approaches for weight loss like diets , physical activity ,pharmacotherapy, Endoscopic treatment , weight loss surgeries .
The best treatment depends on right approach at right time depending upon age , height , weight , BMI and comorbidities And past attempts of weight loss
Ideally the best attempt is ideal diet and physical activity to prevent weight gain.
Choice of therapy can be based on various factors like
Body fat percentage
Body mass index
Evaluation of diseases directly induced by obesity
Psychology impact if any
Evaluation of long term risks

Yes, Bariatric Surgery is the ideal most treatment for long term weightloss as it helps in correcting the root cause and treating the metabolism of the patient. The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity

There are multiple types of bariatric surgeries and there are reversible surgeries as well. But till date no patient has wished for a reversal because no patient would want the weight and co-morbidities and health problems to come back. Unless in a case of cancer in the last 50 years of bariatric surgery no patient has required reversal.

Anybody with a BMI of more than 32.5 kg/sq. can ideally undergo the surgery. Even people with 25 kgs extra weight are suitable candidates & benefit substantially for the management of associated diseases like diabetes, snoring, irregular periods & infertility. If you have Type II Diabetes and it is uncontrolled with medications you may consider the option of metabolic and Bariatric Surgery.
It is not for the weight but for reversal of diseases like Osteoarthritis, Sleep Apnea, Infertility, breast development in young males, Urine incontinence in females with central obesity, recurrent Hernia with obesity, Hiatus Hernia, and Reflux Disease, Varicose Veins, Migraines, and headaches, etc

No, every patient will lose weight after bariatric surgery. The weightloss may vary from person to person but each one loses weight.

One bariatric surgery is ideally enough. But out of 100 patients there may be 4-5 patients who may require a second stage corrective procedure.

Generally, Bariatric surgery now, with the advancement in the science and equipments can be done as a day care procedure at an International Centre of Excellence with a certified team of experts. The patient may get admitted the same day, get operated and can go back home. But ideally it is advicable to get admitted a night prior and get discharged the next day of surgery.

In the first 3 months a patient loses an average of about 15-20kgs depending on the persons excess weight, height and BMI the weight loss may vary from person to person. The surgery brings a drastic change in the metabolism there by inducing a significant weight loss which may not be possible otherwise.

The maximum amount of weight one loses depends on the persons excess weight and height. It may vary from person to person. But the highest weightloss that we have experienced in our unit is 214kgs. The lady who lost that weight has her name in the Limca Book of Records, India Book of Records and World Book of Records. She weight 300kgs in 2015 and now she weighs 96 kgs. She lost a whopping 214 kgs. Another such patient was th3e "Heaviest Britisher who was 310kgs and weighs about 100kgs now 12 years after his surgery.

No, it is not possible. Bariatric Surgey brings about a significant change in ones metabolism and induces energy utilization thereby bringing about weight loss. Hencea person not losing weight after bariatric surgery is unheard of.

Weight gain is a long term physiological phenomenon. As age progresses ones Metabolism starts slowing down and a tendency for mild weight regain can be there. Generally a patient who loses 50kgs in a years time can gain about 5-10kgs over the next 5-10 years however weight gain after bariatric surgery can be minimised by focus on appropriate nutrition, micronutrition support and if needed there could medicines or pharmacological agents which could be added to prevent this weight regain after Bariatric Surgery.

Sometime Antibiotics may disturb the digestive flora or bacteria in the intestine and absorption can be affected. It is not a pleasant way of losing weight infact prebiotics and probiotics need to be taken after antibiotics if there is disturbance in the bowel.

Losing weight too fast or too rapidly is hazardous and sometimes it is not possible. The scientific way of losing weight is by restricting diet, improving physical activity, adding some treatment like medications. Generally this kind of weight is lost in very huge patients where excess weightloss is very high only after Bariatric Surgery. The treatment has to be based on a person's BMI, total excess weight, lifestyle, genetics and an ideal obesity centre should design the weightloss treatment for the patient.

The best way to reduce body fat is by using some scientific method of weight loss and at the same time try and improve your lean muscle mass by increasing your protein intake and excercising under the supervision of an obesity expert. Sometines people have more fat, less muscle mass like Indian genetics but this much drastic fat loss may not be possible everytime but one needs to work on increasing the lean muscle mass and increasing your body fat percentage as far as possible as that is going to be healthy. Such drastic change in body fat percentage from very high to very low may be achieved after treatments like metabolic and bariatric surgery.

Ketogenic Diets have shown promising results in weight loss. It is a low carb, high fat and moderate protein diet which helps the body to lose weight using the ketone bodies. However these diets are supposed to be done under supervision and for a specific period of time and they cannot be done for lifelong. Hence the chances of weight gain post Keto diet is more.

Fat to slim surgery is always benifical for any patient. It is always plesant. However there is change in body size change in measurments, there could be new alterations in the clothes.. Apart from that, because there is change in the energy consumption patient must consume high protein diet and all the required vitamins and micro as well as macro nutrients required for the same and the side effects can be kept minimum.

Generally an individual with body fat or body weight more than 25 kgs is known to be morbidly obese. Such people are best benifited scientifically by metabolic and baraitric surgery. These can induce a weight loss of upto 30kgs. The weight loss happens gradually over a period of 6 months to 1 year during which time the persons metabolism improves and helps that person to lose and maintain that weight over a long time.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. However some patients with malabsorptive procedure may have to focus more on micro nutrient supplementation, a regular followup, a regular blood workup is mandatory to minimize any hazards related to the procedures. In case there are any complications the patient should seek help from experts and senior surgeons who has practice of more than 10 years with Bariatric procedure.

Rarely anyone would regret after Bariatric Surgery because it induces weight loss, the person feels lighter, feels more energetic, his health becomes better, immunity becomes better, diabetes, joint pain, infertility and all such co-morbidities are resoloved. Hence it is very difficult to find anyone who regrets undergoing Bariatric Surgery.

Anyone BMI falls between 25 and 29.9, you are overweight. If your BMI is 30 or higher, you are considered obese. However, you may have an excess fat percentage in your body even though the total weight looks less. If this excess fat is causing diseases like diabetes, hypertension, psychological discomfort and resistant to medical treatment, you may be a candidate for metabolic treatment.

It is generally thought that the best way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

This is surely a difficult situation. Ideally she should be taken to an obesity specialist who has long term experience with childhood obesity and its treatments. Also, rather than just putting her on a diet and making her indirectly or polietly realize that, the whole family can bring abaout changes in lifestyle, ie., making dietary changes, reducing sugars and oil consumption, introducing some form of physical activity and sitting down with the whole family ans explaining that these changes are made for the health of the family would be an easier way to help her. Apart from that, if she continues to gain weight you may take her to an obesity expert and an endocrinologist to rule out any other cause or hormonal impact on her health.

There are different approaches for weight loss like diets, physical activity, pharmacotherapy, Endoscopic treatment, weight loss surgeries. The best treatment depends on right approach at right time depending upon age, height, weight, BMI and co morbidities, past attempts of weight loss. Ideally the best attempt is ideal diet and physical activity to prevent weight gain. Choice of therapy can be based on various factors like Body fat percentage, Body mass index, Evaluation of diseases directly induced by obesity, Psychology impact if any and Evaluation of long term risks.

Some of the scientific ways of losing weight are lifestyle modifications ie., diet and exercise, pharmacotherapy and endoscopic, weightloss procedure. The best treatment for obesity depends on the age, height, weight, BMI, health problems occuring with obesity and the right approach at the right time. All these factors decide which would be the most scientifc treatment at that point of intervention.

When breast tissue in males swells due to hormone imbalance, it is called Gynaecomastia. The male hormone ie., the testosterone levels decrease and/or the female hormone ie., oestrogen levels increase. Obesity leads to reduction in the male hormones in male thereby giving rise to gyneacomasita. A significant weight loss needs to occur in order to bring about a reversal of the female hormone to male hormone. Exercises, Medicines rarely cure or completely treat the hormonal change. In order for the root cause to be treated the person needs to treat obesity completely so that hormonal change and gyneacomastia are both treated. Metabolic and Baraitric surgery is once such treatment that can cure both gyneacomastia and obesity. Just Surgical treatment of gyneacomastia can be done only in patients who are not over-weight or obese and those who's hormonal levels are normal.

Change in skin due to weightloss depends on the persons age, BMI, Health realted problems, weight loss attempts. The skin has a natural tendencay to fully stretch and come back to its normal texture 2-3 times. Generally for females that chance is lost during pregnancy. And apart from that if there are any weight loss attempts the skin gets stretched again. Hence a weight loss treatment not only requires to be life long but also adequate with nutrition and vitamins for beautification and skin.

The type of procedure anyone undergoes depends on the patients age, BMI, Co- morbidities occuring with obesity, the type of food and lifestyle a patient follows. For a person who weighs 340lbs, all types of surgery can be performed based on the clinical opinion from the surgeon and a detailed consultation with the patient.

Any form of weight loss is like a physical stress to the body and if not in the right way and gradually it gives rise to hair fall as the nutritional deficiencies that occur due to the weight loss that affect thehair follicles and induce hair fall. Any good and ideal weight loss treatment always focuses on supplementing the weight loss with appropriate micro and macro nutrients in order to minimize hairfall.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. However some patients with malabsorptive procedure may have to focus more on micro nutrient supplementation, a regular followup, a regular blood workup is mandatory to minimize any hazards related to the procedures. It is always plesant. However there is change in body size change in measurments, there could be new alterations in the clothes.. Apart from that, because there is change in the energy consumption patient must consume high protein diet and all the required vitamins and micro as well as macro nutrients required for the same and the side effects can be kept minimum.

It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

Weight loss stratergy whether a working man or woman depends on the evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. Based on these factors and the persons age, BMI, co-morbidities the weight loss treatements and startegies could vary from dietary modifications, pharmacotherapy, endoscopic balloon treatment and bariatric and metabolic surgery. The effect of each treatment if different and there can never be a simple method.

If all parameters are within the normal range and the patient deems fit for anaethesia by an anaestethist then the surgery can be planned at the earliest.

Type 2 Diabetes is invariably in majority of the patients with some grade of obesity or some excess fat in the body. Fat is known to increase insulin resistance and losing that fat can improve insulin resisctance. However for reversal of diabetes, significant weight loss ie., almost 70% of excess weight loss and mainintaing that lost weight for long term is needed. Recently there are papers published on reversal of diabetes with Very Low Calorie Diet ie., only 600-800calories per day for 3 months. However feasibility of such a low calorie diet is questionable and that is why it is not widely practiced in clinical practice. However weight loss through metabolic surgery for diabetes is known to induce significant weight loss as well as add other hormonal mechanisms that reverse diabetes. and hence reversal of diabetes through metabolic surgery for diabetes and related weight loss is recommended in the guidelines of diabetes treatment by multiple diabetes organizations in the world.

The best way to reduce body fat is by using some scientific method of weight loss and at the same time try and improve your lean muscle mass by increasing your protein intake and excercising under the supervision of an obesity expert. Sometines people have more fat, less muscle mass like Indian genetics but this much drastic fat loss may not be possible everytime but one needs to work on increasing the lean muscle mass and decreasing your body fat percentage as far as possible as that is going to be healthy. Such drastic change in body fat percentage from very high to very low may be achieved after treatments like metabolic and bariatric surgery.

Low -calorie food that is low carb, high protein high fibre, no sugar and low fat. However the ideal composition of these depends on the persons age, weight, BMI, physical activity and co-morbidities. An ideal diet and weight loss food should be adviced by a certified nutritionist or doctor. Hence it is a must to consult an obesity clinic and a multidisciplinary team for the same.

Ideally Bariatric Surgery after preganacy should be planned 3-6 months after the delivery. However there are patient who's BMI is very high and they may have pregnancy induced hypertension, swelling, breathlessness which makes it difficult to take care of the baby. Such patients can undergo surgery at any point of time. The medications for Bariatric Surgery are given only for 24 hours and even lactating mothers can undergo surgery. Bariatric Surgery is intended to make the mother pain-free, mobile, healthy so that she can take care of the baby better. The changes related to pregnancy reverse in about 6 months time. and during this time if the lady does not lose weight and carries the obesity she is eligible to undergo surgery.

Only skipping a meal will not help with weight losss, infact it is important to plan meals rather than to skip meals. Rather than skipping dinner calories need to be spaced out through all the meals in the day. Dinner should ideally be low-carb and rich in protien. But an ideal diet plan will depend on the patients weight, health, co-morbidities and should be planned by a qualified weight loss expert and nutritionist.

Low -calorie food that is low carb, high protein high fibre, no sugar and low fat. However the ideal composition of these depends on the persons age, weight, BMI, physical activity and co-morbidities. An ideal diet and weight loss food should be adviced by a certified nutritionist or doctor. Hence it is a must to consult an obesity clinic and a multidisciplinary team for the same.

Some of the scientific ways of losing weight are lifestyle modifications ie., diet and exercise, pharmacotherapy and endoscopic, weightloss procedure. The most amount of weight one loses depends on the age, height, weight, BMI, health problems occuring with obesity and the right approach at the right time.

The best way to reduce body fat is by using some scientific method of weight loss and at the same time try and improve your lean muscle mass by increasing your protein intake and excercising under the supervision of an obesity expert. Sometines people have more fat, less muscle mass like Indian genetics but this much drastic fat loss may not be possible everytime but one needs to work on increasing the lean muscle mass and increasing your body fat percentage as far as possible as that is going to be healthy. Such drastic change in body fat percentage from very high to very low may be achieved after treatments like metabolic and bariatric surgery.

There is never a complete no to anything after bariatric surgery and it’s the same case with alcohol. Alcohol are basically empty calories and the add on the weight directly. If one asks any doctor irrespective of surgery, they would ideally not advice consumpton of alcohol.

The best way to reduce body fat is by using some scientific method of weight loss and at the same time try and improve your lean muscle mass by increasing your protein intake and excercising under the supervision of an obesity expert. Sometines people have more fat, less muscle mass like Indian genetics but this much drastic fat loss may not be possible everytime but one needs to work on increasing the lean muscle mass and decreasing your body fat percentage as far as possible as that is going to be healthy. Such drastic change in body fat percentage from very high to very low may be achieved after treatments like metabolic and bariatric surgery.

It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

The more the weight loss attempts, more are the chances of the skin becoming lose. Hence one needs to go by a treatment that not only induces weight loss but also helps in the weight maintainance in order to not lead to the loosning of skin. A multidisciplinary team that looks into not just the weight loss treatment but also the required nutrition, multivitamins, exercises so that thw skin does not beomce loose and retains its texture.

The fat cells in the body never really go away, infact the fat in the body is used up by the body as energy and the fat cells shrink in size. Thus one needs to follow weight loss treatments that help in keeping the size of the cells smaller.

Obesity has now been defined as a disease. It can lead to serious health conditions like diabetes, blood pressure, heart diseases and some types of cancer thereby imparing the quality of life and affect psychological health too. Thus treating obesity is important and should not be taken lightly.

Giving up on meat is not the only factor that will make one lose weight. One needs to not just focus on losing weight but maintaining that weight is also equally important. One should ideally follow low-carb, low fat and rich in protien diet plan. But an ideal diet plan will depend on the patients weight, health, co-morbidities and should be planned by a qualified weight loss expert and nutritionist.

Stretch marks appear when the skin fully stretches and Striae or stretch marks appear when the middle layer of the skin tears and the deeper layers of skin is seen through it. When one has multiple weight loss attempts the skin stretches and shrinks again thereby causing expansion and contraction of the skin. A significant weight loss with not much ups and downs and proper nutrition, multivitamins along with massage and exercises can help with the stretch marks.

The best way to reduce body fat is by using some scientific method of weight loss and at the same time try and improve your lean muscle mass by increasing your protein intake and excercising under the supervision of an obesity expert. Sometines people have more fat, less muscle mass like Indian genetics but this much drastic fat loss may not be possible everytime but one needs to work on increasing the lean muscle mass and decreasing your body fat percentage as far as possible as that is going to be healthy. Such drastic change in body fat percentage from very high to very low may be achieved after treatments like metabolic and bariatric surgery.

The amount of weight one loses post bariatric surgery depends on the age, BMI, excess weight, weight loss attempts and many other factors but on an average maximum weight is lost in the first couple of months after the surgery and the weight loss process continues to about one year post surgery. Not just weight loss, focusing on the co-morbidities and their resolution is equally important. AT the end of one year, one loses about 50-80% of their excess weight.

People having Bariatric surgery always enjoy the phases of weight loss, change in confidence, change in their clothes size, new shopping etc. Most of their co-morbidities like diabetes, blood pressure, joint pain, resolve. However there is less intake, patients need to focus on multivitamins and have regular follow-up. Of course , lifestyle change is always a challenge for everyone, however the team will always teach them how to change and improve their lifestyle. Some times they have to work on improving their skin tone by exercise, massage, nutrition, vitamins, and some times if neeeded some patients may even need an asthetic correction after bariatric procedure. The most important challenge is longterm maintainence of the lost weight after the bariatric procedure and no one wants to lose it. There are medications to improve metabolism which can be started a few years after bariatric surgery that can help with weight maintainence over a long period. Incidence of Gallstone formation after any weight loss treatment are know. After Bariatric surgery there are medications for prevention of Gallbladder stones. However, a person needs to follow by ultra sonography to check on the gall stone formation one a year.

Weight loss though a major benefit of bariatric surgery is not the only factor that changes post the surgery. All co-morbidities that co-occur with obesity viz. Diabetes, high blood pressure, joint pain, psychological dysfunction, thereby affecting the quality of life all either resolved or go into remission. In females hormonal changes that can lead to PCOD, irregualr menses, facial hair growth etc can be reversed by surgery, similarly gyneacomastia or breast development and conversion of male hormones to female hormones can also be reversed with weight loss after bariatric surgery. The patient becomes confident, pain-free, healthy and happy.

Weight lost during preperation is genreally with Very Low Calorie diet, medications and supervised preperation. This preperation is strictly done and after all investigations and the surgery date is tentatively decided. This perperation is ONLY for that short durtion and can have other medical implications if continued for longer duration. Medications and diet both become ineffective after a point as the metabolism tries to compensate and bring back the weight. It is almost impossible for anyone to follow such a low calorie diet life long, and it is only when the diet is followed for life long can a person lose and maintain the weight for such long duration.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. However some patients with malabsorptive procedure may have to focus more on micro nutrient supplementation, a regular followup, a regular blood workup is mandatory to minimize any hazards related to the procedures. It is always plesant. However there is change in body size change in measurments, there could be new alterations in the clothes.. Apart from that, because there is change in the energy consumption patient must consume high protein diet and all the required vitamins and micro as well as macro nutrients required for the same and the side effects can be kept minimum.

Bariatric surgery is a surgery performed either on the stomach or the intestine. the stomach size is reduced in such a way that the hunger hormones reduce and therefore the cravings significantly reduced. Patient can maintain himself or herself by eating smaller portions of food and at the same time getting the satisfaction of a full meal because there is satiety. The hormones in the intestine also stimulate the centre for metabolism, reduce hunger, improve utiliztion of fat and conversion into energy. Because these are hormonal actions and the intake becomes less through actions on the brain and hypothalamus. The results are maintained over long term. There could be variability in the results of weight loss in different individuals as this is based on genetics and how early the person takes the decision to take treatment. Those who are called super obese may need to work more aggressively to improve their weight loss to the maximum. Genreally hypertension, daibetes are resolved after surgery, the pain reduces, and patient becomes more active. Hoever remianing active, learning nutrition from the bariatric nutritionist is very important to achieve and maintain the weight loss. Bariatric suregry is a tool to induce wieght loss and everyone need to learn lifestyle change, regular followup and guidelines is the key to success and anyone who follows this will be sure to get a good result post bariatric surgery.

Most people generally think that starvation can be a solution to weight loss. However starvation cannnot be an ideal method to lose weight as shown in many researches. Starvation can temporarily reduce the caloric intake and make one a few kilograms lighter in the initial period. However starvation starts stimulating the bodies compensatory hormones like the hunger hormones start working on the persons brain which will start increasing and the person hunger and the person starts feeling more hungry and that is why startvations cannot be maintained over a long period. However intermittent fasting or starvation for a certain period can work in some people. ANy method that can be maintained for a long duration is the only method which is the best method for that person. Short term weight loss by any modality will eventualyy lead to yo-yo dieting or weight loss followed by more weight gain and hence it is not generally recommended. Body's physiology is not designed by god for starvation and hence starvation is not a natural modality to attempt weight loss or any treatment. Reducing calories by any modality be it lifestyle change, diet, medications or bariatric surgery is the best way to achieve partial starvation or restrction of food over the long term and that is known to be the best method in the long term. Without the above any attempt of starvation eventually will lead to more weight gain in the long term inspite of havingsmall weight loss over a short period. There are incidences where for religious reason people fast (ie., starve) for a long duration but they do not lose significant amount of weight or they lose any weight at all. It has been seen starvation or very low calorie diet for a few weeks is known to stimulate the hunger hormone and stimulate the metabolism to gain weight even at the slightest calories intake. And hence any attempt of weight loss should be done under medical supervision at a obseity or bairatric unit under the guidance of a bariatric physician, nutritionist, psychologist based on the patients inestigations, evaluation, age and BMI.

Obese people are known to have altered or slower metabolism and obesity is known as a disease of various hormones, metabolism and genetics. That is why obese people cannot voluntarily control their diet. Feeling hungry and controlling diet is not a conscious decision they are actually functions of body's hormones scereted by various parts of intestine including the stomach, small and large intestine. If there is an alteration in these stimuli it is very difficult to control the diet. Even though there tricks of controlling diet by changing the diet composition but it is difficult to maintain it over long term especially in todays era where the diet is rich in calories, most ofetn readymade and raw food is not palatable. The stimulation of diet depends based on the stimulation of hunger hormones secreted by the stomach. If a person starts controlling diet and losing weight, in an obese patient body's physiology starts secreting a hormone called ghrelin which is also known as hunger hormone which starts working on the persons centre of hunger and makes the person more hungey thus making the obese person hungrier. However there are medications that can supress appetite, a long term gradual lifestyle change can help them even though it is very difficult. Bariatric surgery is known to control hunger and diet which is not by reduction in size o stomach but by acting on the cebtre of hunger and satiety.

Exercise is ideally supposed to be for better health, better muscle health, better insulin resistance. exercise cannot be an option for weight loss and no where it is recommended as a treatment for weight loss. exercise should ideally be used for weight loss maintenance and better health and better resistance. However What exercise should be done should be based on what a patients muscle health bone health mobility and the patients BMI. If there is too much of excess weight on the exercise can strain and sprain certain joints if weight is an excess of 20 to 40 kgs. Have such patients should have ideally non weight bearing exercises. However exercises can be upgraded after surgery as the person starts losing weight and when the patient loses maximum weight all types of exercises are possible and are also recommended. exercise does not necessary mean artificial supplements. Protein supplements after bariatric surgery should be very carefully chosen which are given typically for bariatric surgery patients. Exercises with heavy weight can lead to joint damage leading to severe complications, so ideally light physical activity like walking or low intensity exercises like hand rotations, neck rotations, ankle rotations at your own pace are advisable. Along with it breathing exercises are the most important as weight causes compression of lungs and to open it breathing exercises helps appropriately helping you to be physically active to the maximum extent.

Asians are known to have more body fat as compared to westerners and anyone with a weight in excess of 20-22kgs in comparison to their ideal weight which does not respond to medical treatment, quaifies for bairatric surgery. Generally a body mass index of 32kg/m2 with comorbidities is called morbid obesity in asian guidelines and any such patients should be advised bariatric surgery as per the scientific guidelines.The comorbidity status and faiure of medical weight loss are main indication where a decision of bariatric surgery is taken.The comorbidities could be variable for age and based on BMI.For example a young girl may have PCOD,Hirsutism Excess hair growth on face,loss of confidence will have significant psycosocial comorbidities but lab parameter may be normal yet she would qualify for bariatric surgery. The ideal evaluation for bariatric surgery is evalution of hormones,all the systems sonography whenther the patient has pre diabetes or the cholesterol is normal ,the vitamins status and after evalution all of this nutritionist,psychologist, a bariatric physician and a bariatric surgeon would evalute patient for a appropriate type of surgery.After this the patient should be explained the pros and cons and long term maintainence and after understanding all of this the patient should take the desicion of bariatric surgery. The pre op evaluation, the understanding, the long term care are one of the most important aspects of bariatric surgery. Patients who have very large liver, breathing problems may be put on a preperation of low calorie diet for a period of 5-15 days to prepare their liver, induce some weigtloss and keep them prepared and make them lower risk for surgery. any centre that is accrediated and follows the best international guidelines is a centre where the patient should seek bairatric surgery.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. Results of gastric bypass or sleeve gastrectomy or different types of gastric bypass between 1 to 5 years are almost the same and weight loss maintenance is more important in the long run. It is extremely important to know the size of food one should consume at one time and maintain that portion size in the long run to ensure that the weight and the benefits are maintained in the long term. It is not important as to how much you eat but it is important to know what you eat whether the composition suits your body's metabolism. however In a sleeve gastrectomy there is a pyloric valve even intake of liquids could be restricted all types of intake could restricted because of the valve which proves beneficial to the patients. In a gastric bypass because the stomach is connected to the intestine without a valve the passage of food could be easier however it should not be taken as an option to eat more. What is more important is to get satisfaction of eating and getting a sensation that you have eaten enough and you have enjoyed everything which just possible after any type of bariatric surgery. However diet protocols could be based on BMI, metabolism, expected target of weight loss, patients age, health and multiple such factors. Consulting a bariatric nutritionist in a center of excellence is ideal way to know understand how much should be by a patient after bariatric surgery.

Obesity is a disease in itself and it requires life long treatment. Some of the effects of obesity are immediate and some effects occur over time but both significantly affect daily living. Joint pain, Urinary Incontinence due to huge central obesity, sexual dysfuntion, snoring all affect a patients confidence and self esteem. These are changes that occur within a short duration and affect the qualtiy of life, relations and health. Similarly diabets, high blood pressure, heart diseases, and some types of cancer can occur over time when the obesity is long lasting. Thus obesity and its co-occuring health problems do signinficantly affect daily living and qualtiy of life.

The amount of weight one loses or wises to lose doent purely depend on the number of calories consumed. Rather it depends on a persons metabolism. For exapmle, if a persons metabolism is fast even consuming as much a 5000-6000 calories a day wil not give rise to weight gain, whereas some one who's metabolism is slow even eating as less as 700-800 calories a day can give rise to weight gain. It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

Health problems can be completely reversed or may stay depending on the weight loss treatment. The weight, BMI, weight loss attempts, age gender are all deciding factors for concluding if a weight loss treatment will work or not. If the treatment works there will be reversal of health problems if not the problems will continue. For example, Asians are known to have more body fat as compared to westerners and anyone with a weight in excess of 20-22kgs in comparison to their ideal weight which does not respond to medical treatment, quaifies for bairatric surgery. Generally a body mass index of 32kg/m2 with comorbidities is called morbid obesity in asian guidelines and any such patients should be advised bariatric surgery as per the scientific guidelines.The comorbidity status and faiure of medical weight loss are main indication where a decision of bariatric surgery is taken. In such situations if the persons continues with medical or pharmacological treatment then the compensatory mechanisms work against the treatemnt and the health problems can come back and stay. Similarly, if a person attempts multiple times to treat the weight and its related health problems and if the treatments are unsuccessful then even with surgical treatment the changes in the bdy can be such that they may stay and can never be reversed. Hence understanding what treatment is best at what time is the ideal treatment and deciding factor. The person should best be seen by a multidisciplinary team of obesity specialists who can help make the best decision based on the history of the patient.

Yes, normalizing obesity does make it dangerous. Infact all national and international obesity and health organiztions have now defined obesity as a disease. And a disease just like obesity affects all areas of life and functioning. It has health implications, psychological implications thereby affecting the qualtiy of life. The health risks associated with obesity are Diabetes, blood pressure, joint pain, sleep apnea or snoring, heart disease, low self esteem and confidence most of which people are unable to correlate with obesity. This inability to correlate can affect a persons perception o obesity as a disease.

Diet post bariatric surgery is as per the American guidelines for surgery. The diet varies from clear liquids for the first 10 days to thicker, pureed food and then soft to normal diet over a period of one to two months. The diet though standardised, the dietary options are specific to each country, state and dietary habits. Generally the suture line takes about 6-8 weeks to heal, in that period the dietary phases of a person change and move to the next phase.

Some of the scientific ways of losing weight are lifestyle modifications ie., diet and exercise, pharmacotherapy and endoscopic, weightloss procedure. The most amount of weight one loses depends on the age, height, weight, BMI, health problems occuring with obesity and the right approach at the right time.

There are different approaches for weight loss like diets, physical activity, pharmacotherapy, Endoscopic treatment, weight loss surgeries. Generally, the first line of treatment though is diet and exercise, whether it will work for a patient or not depends on the right approach at right time depending upon age, height, weight, BMI and co morbidities, past attempts of weight loss. Weight loss pills can be effective if combined with diet and exercise and are generally given to someone who ranges between the BMI 25-28kg/m. Any BMI higher than that, the metabolism changes and the person is unable to lose weight or maintain the lost weight with the modality of weight loss pills. In such patients the weightloss pills prove to be ineffective. Hence the treatemnt that one attepmts to follow should be adviced by an experienced team of experts who have adviced such treatments.

Obesity is a disease in itself and it requires life long treatment. Some of the effects of obesity are immediate and some effects occur over time but both significantly affect daily living. Joint pain, Urinary Incontinence due to huge central obesity, sexual dysfuntion, snoring all affect a patients confidence and self esteem. Apart from these Daiabets, high blood pressure, certain types of cancers heart problems are someof the main consequences of obesity that impact all areas of life and functioning.

Over weight and obesity both can have a significant impact on a childs health and psychology. High blood pressure, diabets at a young age, breathlessness, asthama, snoring, high cholestrol levels at a very young age are some of the major health problems that could be harmful for the child's health. Similarly, lack of confidence, low self esteem, depression, inability to concentrate can be some of the psychological problems that affect the child along with the health problems. Treatment from a young age will help such children as they grow older. Obesity needs to be looked as a disease rather than just a cosmetic concern. Certain hormonal impact of obesity can remain and hamper even in adulthood. Hormonal changes can give rise to hypogonadism, breast development in young males, excess hair growth, irrgular menstrual cycle and PCOD in females. If not corrected at a young age these problems can be carried into adulthood and affect after life.

Exercise is ideally supposed to be for better health, better muscle health, better insulin resistance. exercise cannot be an option for weight loss and no where it is recommended as a treatment for weight loss. exercise should ideally be used for weight loss maintenance and better health and better resistance. It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always. What weight loss treatemnt is best for whom should be decided by a team of specialists who have experience in treating obesity over a long duration.

Only losing fat without losing weight may be almost impossible. using some scientific method of weight loss and at the same time increasing the lean muscle mass by increasing your protein intake and excercising under the supervision of an obesity expert is a must. Sometines people have more fat, less muscle mass like Indian genetics hence fat loss may not be possible everytime but one needs to work on increasing the lean muscle mass and decreasing your body fat percentage as far as possible as that is going to be healthy. Such drastic change in body fat percentage from very high to very low may be achieved after treatments like metabolic and bariatric surgery. Bariatric surgery induces fat utilzation and coversion to enerygy.

Laxatives make one lose weight only temporarily. Laxatives basically bring all the water from the intestine into the stools thereby the weight that is lost is from this water. Laxatives work on the large intestine and the food before it reached the large intestine is generally absorbed, thus the calories are already absorbed by the body. The process of weight loss by using laxatives can lead to a lot of other health problems like dehydration, electrolyte imbalance, chronic constipation with dependence on the laxative. Laxatives are only a temporary solution and cannot be used as a long term treatment for weight loss. Some of the scientific ways of losing weight are lifestyle modifications ie., diet and exercise, pharmacotherapy and endoscopic, weightloss procedures. The best treatment for obesity depends on the age, height, weight, BMI, health problems occuring with obesity and the right approach at the right time. All these factors decide which would be the most scientifc treatment at that point of intervention.

Most often the pain in the legs resolves and/or disappears after bariatric surgery because excess weight on the joints, tissues and muscles is taken away. However sometimes patients drag their decision to get operated for too long keep on attempting other options of treatment during which time there could be some long-term damage to the joints or muscles in such cases treatment for that damage as well as bariatric surgery both are needed. There are some other reasons for this pain which could be electrolyte deficiency, vitamin deficiency can also be a reason for such pain and therefore all the bariatric surgeons and the team would suggest the patient to consume adequate amount of fluids and take the necessary supplementation. The patients are also adviced to check their vitamin status, nutritional status biochemically by a regular blood work.

Certain tips for a patient who are undergoing bariatric surgery: most importantly and the first one to understand that obesity is a disease, its complex disease of hormones, metabolism, genetics and environmental factors and there is no quick fix or shortcut. however it is very important for a person to understand that when the BMI reaches more than 35 and some associated comorbidity, the decision of bariatric surgery should not be delayed for too long otherwise the results of the surgery can get partly affected because of the delay it is important to have a thorough evaluation and consultation with a nutritionist psychologist position and a bariatric surgeon prior to surgery and worked up as per the best international guidelines should be conducted before prior to bariatric surgery that team will connect you to earlier operated patients or support groups and that is an important part to understand the journey of bariatric surgery and life after that bariatric surgery is a tool to lose weight and lifestyle change added to it will make it more successful and long lasting advice regarding nutrition and Vitamin and micro and macro nutrients implementation should be followed very sincerely to get the best results however because the patient is very thoroughly investigated tried Virk surgery many of the nutritional deficiencies are the diagonals in time patient is made aware and we find that the deficiency is after bariatric surgery are far less than deficiency in the routine obese people.

Exercise is ideally supposed to be for better health, better muscle health, better insulin resistance. exercise cannot be an option for weight loss and no where it is recommended as a treatment for weight loss. exercise should ideally be used for weight loss maintenance and better health and better resistance. However What exercise should be done should be based on what a patients muscle health bone health mobility and the patients BMI. If there is too much of excess weight on the exercise can strain and sprain certain joints if weight is an excess of 20 to 40 kgs. Have such patients should have ideally non weight bearing exercises. However exercises can be upgraded after surgery as the person starts losing weight and when the patient loses maximum weight all types of exercises are possible and are also recommended. exercise does not necessary mean artificial supplements. Protein supplements after bariatric surgery should be very carefully chosen which are given typically for bariatric surgery patients. Exercises with heavy weight can lead to joint damage leading to severe complications, so ideally light physical activity like walking or low intensity exercises like hand rotations, neck rotations, ankle rotations at your own pace are advisable. Along with it breathing exercises are the most important as weight causes compression of lungs and to open it breathing exercises helps appropriately helping you to be physically active to the maximum extent.

Weight gain is a long term physiological phenomenon. As age progresses ones Metabolism starts slowing down and a tendency for mild weight regain can be there. Generally a patient who loses 50kgs in a years time can gain about 5-10kgs over the next 5-10 years however weight gain after bariatric surgery can be minimised by focus on appropriate nutrition, micronutrition support and if needed there could medicines or pharmacological agents which could be added to prevent this weight regain after Bariatric Surgery. A qualified team of nutritionist, psychologist, physician and surgeon in a certified high volume bariatric setup can best help with the weight loss as they have experience dealing with such treatments. Also, since the physiology post bariatric surgery of the stomach and intestine are differnt standard treatments for weight loss may not work well with such patients and infact worsen the weight loss process. ALos, patients also need to remeber that obesity is a disease just like diabetes, blood pressure and it will require life long treatment. A weight gain of a few kilos can be managed with diet and phsrmacotherapy very easily, the patient just needs to come back for a follow-up then and there and take treatment.

Loose skin post bariatric surgery could be due to various reasons. it depends on the age, BMI, initial weight of the person. Number of weight loss attempts prior to weight loss surgery can also affect the skin laxity. More the weight loss attempts more the skin streches to its maximum and comes back to normalcy. This frequent stretching of the skin is what leads to the laxity. The age of the person also plays a role , as the age increases the skin loses its tenacity. Post bariatric surgery the skin can be tightened by exercise, nutrition, massage and diet and a multi disciplinary team at a Centre of Excellence will guide you about the same. There are various cosmetic corrections that can be surgical as well as non-surgical which the patients may undergo if there is a lot of laxity.

No, weight loss surgery does not shorten life. Infact Bariatric Surgery improves life and quality of life as well. Bariatric Surgery helps in correcting the root cause and treating the metabolism of the patient. The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity. All of this not just improves health but also lengthens life and improves the quality of life as well.

The Asian guidelines for overweight or obesity are different from European and American guidelines as Indians have a higher fat percentage as compared to their European and American counterparts.
Being overweight or obese can be calculated by either method of BMI calculation, Waist Circumference, or a more advanced method of Body Fat Percentage with the help of Body composition.
BMI is calculated by kg/m2, where a person's weight in kilograms and m2 is their height in metres squared.
A Normal BMI lies in the range 18-22.9kg/m2, BMI between the range 23-24.9kg/m2 is defined as Overweight, BMI >=25kg/m2 is defined as Obese and any BMI 32.5kg/m2 is defined as Morbidly Obese.
A Waist Circumference >80cms in Females and >90cms in Males is an indication of Obesity
Similarly, any person with a Body Fat Percentage of >20% is defined as Obese and a person with a Body Fat Percentage of >30% is defined as Morbidly Obese
If a person falls under any of the above categories of BMI, Waist Circumference or Body Fat Percentage they are defined as overweight or obese.

It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

Just removing the fat from the lower layer of the skin through liposuction will not have an effecton diabetes, infact for a person with diabetes removal of fat can affect wound healing if the diabetes is uncontrolled. Excess abdominal fat is associated with a defect in insulin's ability to regulate sugar and fat metabolism, which can lead to metabolic diseases such as type 2 diabetes, hence A tretment that will help change the metabolism and also not only reduce abdominal fat but also put the diabetes into remission is an ideal treatment. Bariatric surgery is one such treatement that will treat both abdominal fat as well as diabetes by bringing about changes in the hormones, inducing diabets remission

Yes, Bariatric Surgery is the ideal most treatment for long term weightloss as it helps in correcting the root cause and treating the metabolism of the patient. The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity

Liposuction is a cosmetic correction treatment and can be done for someone who is 5-8 kgs excess weight. It is ideally not done as a weight loss treatment. In Liposuction the fat under the skin is removed using a suction cannula but nothing is dont to the fat that is on the organs inside. For someone who has more than 10kgs excess weight may not benifit much from lipsuction since not much is done to the metabolism and the body will start storing fat again over time and at different places in the body. Treatments that are long term in basically help in changing the body's metabolism from fat storage to fat utilization would be an ideal treatment to prevent the fat cells from coming back and to get a long term solution to fat.

Dieting before weight loss surgery depends on the weight of the person, co-morbidities along with obesity and the experience of the surgeon and operating skills. Ideally a person would be adviced very low calorie diet a week prior to the surgery along with some mobility and breating exercises. All this is adviced to the patient in order to prepare the liver for surgery as almost all obese patients have some grade of fatty liver. Mobility and breating exercises are to prepare the lungs for anasthesia as the abdominal fat compresses the lungs leading to respiratory disorders. The surgeons experience with the patients is also a deciding factor for pre-op preperation, more experienced the surgeon lesser the preper4ation for surgery, younger the surgeon more is the preperation that the patient needs to follow for surgery.

Advantages: People who see you daily, will compliment you and you will discover an all new version of yourself that you never could imagine.The Stamina increases drastically, Confidence improves significantly. Apart from these asthetic changes that occur, one will not only lose weight but also have a significant change in their health and co-morbidities that come along with obesity like diabetes, high blood pressure, PCOD, Joint pain, heart health etc. Some of the disadvantages to name a few are, Gastric Bypass being a malabsorptive procedure one will have to be on Multivitamin supplements life long, but generally they can be provided in the form of drinks, chewable sweets hence one may not feel like they are on medications and yet get the same benifits.Any weight loss treatment can lead to some thinning or loss of hair in the first few months after bariatric surgery. This is mainly temporary and will imrpove with time, only regular followups and medications need to be followed for the same.

Obesity and overweight are linked to several factors that increase ones risk for cardiovascular disease. It can change your cholesterol levels. It can cause the bad cholesterol and triglyceride levels to rise, thereby increasing the risk for heart disease.

It can cause your blood pressure to rise. Obese individuals require more blood to supply oxygen and nutrients to their bodies which causes an increase in blood pressure. Your body will also require more pressure to move this blood around. High blood pressure is also a common cause of heart attack especially in obese individuals.

Obesity can also lead to diabetes. Obese individuals also have a much greater chance of developing diabetes. Multiple studies show people aged 65 or older with diabetes also have heart disease. While individuals with diabetes are said to be two to four times more likely to be at risk for heart disease, diabetes is one of the top seven major controllable factors to prevent heart disease. If you have diabetes but have yet to be diagnosed with heart disease. Thus treatment that improves not just obesity but also treats diabets and heart health are most effecient forms of treatment.

Giving up alcohol does help in weight loss but it depends on what the baseline alcohol consumption is. If heavier drinkers remove alcohol for a longer period of time, they might see weight loss, improvement in body composition, less stomach fat, improvement in triglycerides. Also, just cutting out on only alcohol will not help with weight loss. A proper diet and exercise if not followed weight gain can still continue, hence lifestyle modifications and changes depending on one's metabolisim and following the right treatment at the right time will be beneficial.

Proper diet and exercise do work, especially when started at a young age and continued faithfully throughout your life. Unfortunately, for people who are already struggling with obesity, the cards are stacked against them. Diet and exercise work more for prevention or during early treatment of obesity.

However, if the body physiology is trying to get your weight back, your attempts to lose weight succeed only temporarily. Once a person's BMI crosses a certain limit, say above 30 kg/m2, the metabolism changes to that of weight regain. Hence, it is not easy to lose weight with diet and exercise if you have severe obesity.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. Results of gastric bypass or sleeve gastrectomy or different types of gastric bypass between 1 to 5 years are almost the same and weight loss maintenance is more important in the long run. It is extremely important to know the size of food one should consume at one time and maintain that portion size in the long run to ensure that the weight and the benefits are maintained in the long term. It is not important as to how much you eat but it is important to know what you eat whether the composition suits your body's metabolism. however In a sleeve gastrectomy there is a pyloric valve even intake of liquids could be restricted all types of intake could restricted because of the valve which proves beneficial to the patients. In a gastric bypass because the stomach is connected to the intestine without a valve the passage of food could be easier however it should not be taken as an option to eat more. What is more important is to get satisfaction of eating and getting a sensation that you have eaten enough and you have enjoyed everything which just possible after any type of bariatric surgery. However diet protocols could be based on BMI, metabolism, expected target of weight loss, patients age, health and multiple such factors. Consulting a bariatric nutritionist in a center of excellence is ideal way to know understand how much should be by a patient after bariatric surgery.

In a Lap band procedure, the surgeon places an adjustable ring around the upper part of the stomach thereby tying off most of the stomach and leaving a very small area. There is severe discomfort if the patient over eats thereby aiding in weight loss. In a gastric sleeve surgery the greater curvature of the stomach pouch that secretes a hormone called ghrelin, excess secereting part of that hunger hormone is removed thereby reducing hunger and cravings. since Lap Band is Less consistently effective than other procedures. Additional adjustments procedures are required, The rate of complications may be higher, Many patients end up seeking revisions to sleeve gastrectomies Whne the two are compared sleeve gastrectomy is the best option amongst the two. Though more invasive and has a longer recovery time, gastric sleeve is way more effective with less probability of reoperation and complication

Exercise is ideally supposed to be for better health, better muscle health, better insulin resistance. exercise cannot be an option for weight loss and no where it is recommended as a treatment for weight loss. exercise should ideally be used for weight loss maintenance and better health and better resistance. However What exercise should be done should be based on what a patients muscle health bone health mobility and the patients BMI. If there is too much of excess weight on the exercise can strain and sprain certain joints if weight is an excess of 20 to 40 kgs. Have such patients should have ideally non weight bearing exercises. However exercises can be upgraded after surgery as the person starts losing weight and when the patient loses maximum weight all types of exercises are possible and are also recommended. exercise does not necessary mean artificial supplements. Protein supplements after bariatric surgery should be very carefully chosen which are given typically for bariatric surgery patients. Exercises with heavy weight can lead to joint damage leading to severe complications, so ideally light physical activity like walking or low intensity exercises like hand rotations, neck rotations, ankle rotations at your own pace are advisable. Along with it breathing exercises are the most important as weight causes compression of lungs and to open it breathing exercises helps appropriately helping you to be physically active to the maximum extent.

There are different approaches for weight loss like diets , physical activity ,pharmacotherapy, Endoscopic treatment , weight loss surgeries . The best treatment depends on right approach at right time depending upon age , height , weight , BMI and comorbidities And past attempts of weight loss Ideally the best attempt is ideal diet and physical activity to prevent weight gain. Choice of therapy can be based on various factors like Body fat percentage, Body mass index, Evaluation of diseases directly induced by obesity, Psychological impact if any and Evaluation of long term risks

Research has shown that a weight gain as less as 5% more than the ideal weight can have negative effect on the heart. Weight gain can affect the structure of the heart which may inturn affect the ability to pump blood, there by leading to heart aliments. Weight gain also puts a strain on the heart, causing it to pump harder, which causes the heart muscle to thicken. People who lose weight actually improve their hearts by decreasing the thickness of the heart muscle, and that probably lowers their risk for heart failure.

Actually calorie restriction will help you lose your belly fat .Diet composition actually matters and diet rich in proteins(from low calorie and low fat sources) ,fibre, lesser carbohydrate lesser sugar and oil will always help you lose your belly fat. Belly fat can still be very resistant because it needs extreme calorie restriction activity and sometimes it is genetic. Other foods like fibres, soluble fibres, insoluble fibres functional foods, correction of vitamin deficiency is like vitamin B12 ,vitamin D also helps to patient loose more weight.However if the belly fat is resistant it is more harmful to the body and is risk factor for diseases like Diabetes, high blood pressure , increased cholesterol levels etc and the person should seek expert opinion from an obesity expert.

Exercise is generally recommended for better health and weight loss maintenance. Exercise cannot be used solely as a tool for weight loss . Science and endocrinologist always state that exercise is not only treatment for weight loss,exercise needs to be combined with an appropriate supervised diet to achieve the best weight loss , both the diet and exercise have to be maintained over a long period of time however in spite of doing that after doing exercise the weight loss platues or stops after sometime and that is because of body's smart adaptation to reduce calories spent after each exercise and therefore the person's metabolism prevents further weight loss and starts the weight regain ,such a person need to seek expert advice from an obesity expert find out the exact reason, exact metabolic rate and any hormonal imbalance and the treatment should be conducted under supervision. It is definitely possible to lose belly fat and is important to lose belly fat because it is it harbours the reason for many diseases .People with fat on belly needs to be evaluted well and they should ideally approach the obesity clinic and qualified obesity expert

Weight gain after any treatment whether it is medical weight loss for bariatric surgery can happen slowly over years, the main reason being as your age advances metabolic rate slows down. Your genetic tendency still continues,the environmental factors still exists and slow weight regain could happen if appropriate care is not taken. A person needs to follow with the Bariatric clinic very sincerely, focus on nutritional supplements and seek dietary advice as and when required.In today's Era there are medications to prevent weight regain after any bariatric procedure and the person should seek advice from best bariatric surgeon for the same. There could be second procedures or redo Bariatric surgery or revision bariatric surgery for 2nd grade surgery after sleeve gastrectomy. About 4 to 5% of patients may need a redo or revision bariatric surgery. If the sleeve is dilated and the amount consumed at one time is very large, even a Re sleeve gastrectomy or a same procedure can be performed again. However generally recommendation is to add more hormonal actions by adding some intestinal element and therefore conversion from sleeve to malabsorptive procedure is more commonly recommended. Even though the person needs a second stage Bariatric procedure it is considered as a second stage of treatment and the person can still lose weight and get rid of his comorbidities and it is scientifically approved. Redo bariatric surgeries are also standardized procedures and should be should be performed in a centers with high volume, large experience and with experience of redo or revision prosedures. Sleeve gastrectomy is a procedure on the stomach where the greater curvature is removed, however it is elastic and it can keep on extending. The person has to remember the amount consumed at a time should be moderate and should not be in excess, however sometimes sleeve dilates and that make you rise to for the weight regain in addition to factors like patient genetic tendency.These can be treated scientifically and the person should get it treated scientifically. Redo bariatric surgeries are typically needed for those who are super obese and initially because this much of excess weight loss to be lost and maintain becomes a challenge for body's physiology, and hence the decision for bariatric surgery should be considered in time before the person becomes super obese is according to the scientific guidelines.

Gallbladder surgery is laparoscopic removal of gallbladder which is disease and has multiple stones. Having multiple stones in the bladder has multiple risks like if the stone slips into the common duct there could be jaundice, if it splits further and get stuck there could be inflammation of pancreas which is called pancreatitis and it can be serious. Long-term gallbladder stones in the gallbladder can have continuous irritation of the gallbladder wall and can even give rise to cancer. Hence gallbladder surgery is performed for gallstone disease and the gallbladder is removed during the procedure. Bile is actually produced in the liver so gallbladder removal does not interfere with digestion or secretion of bile. Actually there is no relation between gallbladder surgery and weight loss, weight loss has to be achieved by scientifically supervised diet, lifestyle changes, if required medication and if morbidly obese- Bariatric surgery.

Rarely anyone would regret after Bariatric Surgery because it induces weight loss, the person feels lighter, feels more energetic, his health becomes better, immunity becomes better, diabetes, joint pain, infertility and all such co-morbidities are resoloved. Hence it is very difficult to find anyone who regrets undergoing Bariatric Surgery.

Following are the reasons which would qualify one for revisional bariatric surgery: Super Morbid Obesity: If a persons initial BMI is above 50kg/m2 they fall under the super obese catogeory, in such patients the weight loss that may be achieved through a primary procedure may be inadequate, in such patients a second stage procedure may be required to bring the weight to near normal. For eg., a lady weighing 300kgs may come down to 150kgs with a primary procedure but 150kgs is still a lot of weight and she may need to lose more, in such patients a second stage procedure will help them achieve their near normal wieght. Another factor could be inadequate weight loss or weight regain: In certain patients due to various reasons like steroid usage, psychiatric medications that could lead to weight gain, poor dietary habits and alcohol consumption could be someof the reasons for weight regain or inadequate weight loss. In such patioents if the BMI is above 35kg/m2 a second stage revisional procedure may be advised.

Yes, Bariatric Surgery is the ideal most treatment for long term weightloss as it helps in correcting the root cause and treating the metabolism of the patient. The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity

The best way to reduce body fat is by using some scientific method of weight loss and at the same time try and improve your lean muscle mass by increasing your protein intake and excercising under the supervision of an obesity expert. Sometines people have more fat, less muscle mass like Indian genetics but this much drastic fat loss may not be possible everytime but one needs to work on increasing the lean muscle mass and decreasing your body fat percentage as far as possible as that is going to be healthy. Such drastic change in body fat percentage from very high to very low may be achieved after treatments like metabolic and bariatric surgery.

Gastric sleeve with the advancment in science and technology can be done almost like a day-care procedure. And the patient almost always walks in to the OT and walks back to the room post the surgery. After this we make sure that the patient is pain free and discomfort free, walking and active. The patient generally gets discharged the next day and can get back to their normal routine once home. A period of 2-3 days is good enough to get back to normal work.

Eating 500 calories a day would be one of the ways of losing weight but if this form of treatment is continued for life long or a couple of years only then it will work. It is important to note that losing weight with this diet may be feasible but maintaning this diet for long durations is almost impossible. Hence one needs to lookj at treatments that are sustainable and possible for a person to follow life long. For someone who's BMI is over 35 kg/m2 even with a 500 calorie diet may not work if the metabolism doesnt support hence in such patients inspite of strictly following the diet, sustainance and maintaninace may be almost impossible.

It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

A decrease in thyroid hormone (increased TSH value, also known as Hypothyroidism) can have an effect on the weight loss process. A weight gain of a few kilos (generally 6-8kgs) is seen in patients whose thyroid levels are deranged. But it must also be noted that once the treatment of thyroid is started and the thyroid levels come to normal even the weight should go down. If that does not happen then the weight gain may not be due to thyroid only. And such patients may require a thorough work-up to see what factors could be leading to the weight gain in the best Bariatric centre nearby.

Gallbladder surgery is laparoscopic removal of gallbladder which is disease and has multiple stones. Having multiple stones in the bladder has multiple risks like if the stone slips into the common duct there could be jaundice, if it splits further and get stuck there could be inflammation of pancreas which is called pancreatitis and it can be serious. Long-term gallbladder stones in the gallbladder can have continuous irritation of the gallbladder wall and can even give rise to cancer. Hence gallbladder surgery is performed for gallstone disease and the gallbladder is removed during the procedure. Bile is actually produced in the liver so gallbladder removal does not interfere with digestion or secretion of bile. If the stone slips and gets stuck in the common bile duct then the surgery can be complicated hence treatment at the right time is essential.

Generally, if surgery for removal of gall bladder is done laparoscopically, it can be done as a day care procedure and the patient is moving about and active in a few hours post surgery. The healing period for the wound is genereally 6-8 weeks and the patient can start with walking immediately but heavy weight training should generally be avoided for a month to 6 weeks so that the wound healing happens well and chances of developing hernia in the abdominal wall.

Losing weight too fast or too rapidly is hazardous and sometimes it is not possible. The scientific way of losing weight is by restricting diet, improving physical activity, adding some treatment like medications. Generally this kind of weight is lost in very huge patients where excess weightloss is very high only after Bariatric Surgery. The treatment has to be based on a person's BMI, total excess weight, lifestyle, genetics and an ideal obesity centre should design the weightloss treatment for the patient.

There are 2 main categories of Fat, Mono-saturated and poly-saturated Fat also called "good-fat" and saturated or trans fat also called "bad-fat". It is generally this bad fat which should be aoided in case of type to diabetes. A normal weight and non-diabetic person is permitted 15-30gms fat but if the person is obese and/or diabetic the fat should be restricted to less than 15gms. This is because the high fat levels lead to insulin resistance there by increasing the risk for type II diabetes.

Yes, Bariatric Surgery is the ideal most treatment for long term weightloss as it helps in correcting the root cause and treating the metabolism of the patient. The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity

Loose skin post bariatric surgery could be due to various reasons. it depends on the age, BMI, initial weight of the person. Number of weight loss attempts prior to weight loss surgery can also affect the skin laxity. More the weight loss attempts more the skin streches to its maximum and comes back to normalcy. This frequent stretching of the skin is what leads to the laxity. The age of the person also plays a role , as the age increases the skin loses its tenacity. Post bariatric surgery the skin can be tightened by exercise, nutrition, massage and diet and a multi disciplinary team at a Centre of Excellence will guide you about the same. There are various cosmetic corrections that can be surgical as well as non-surgical which the patients may undergo if there is a lot of laxity.

A recent study has shown that People with obesity who lost weight as a result of bariatric surgery and who subsequently contracted COVID-19 were less likely to be admitted to the hospital for COVID, and the disease was less severe than among COVID patients with obesity who had not undergone the surgery. Obesity leads to a weakend immune system. obesity is a condition of chronic inflamation and this inflamation can lead to excess cytokin production and the same happens with the COVID infection as well there by doubling the damage to the organs. obesity increases the risk for cardiovascular disease, hypertension, diabetes, kidney disease and blood clot formation. Those conditions can lead to poor outcomes after an infection like COVID. Many patients with obesity have underlying lung conditions, such as sleep apnea and obesity hypoventilation syndrome, that can worsen the outcomes of COVID-19 pneumonia. Studies have now shown that patients who have undergone bariatric surgery are safe and healthier to fight the COVID Infection due to the improvement in their inflamatory markers, health co-morbidities and better lung capacity.

Change in skin due to weightloss depends on the persons age, BMI, Health realted problems, weight loss attempts. The skin has a natural tendencay to fully stretch and come back to its normal texture 2-3 times. Generally for females that chance is lost during pregnancy. And apart from that if there are any weight loss attempts the skin gets stretched again. Hence a weight loss treatment not only requires to be life long but also adequate with nutrition and vitamins for beautification and skin. If the patient is young, the skin may contract and no surgery may be required but if the patient has had multiple weight loss attempts where the skin has stretched completely and gone back to norrmal after the weight loss, such weight loss may not be healthy and may affect the skin and texture and in such patients massage, exercise and nutrition by itself may not work and such patients may require cosmetic correction for the skin after a significant amount of weight loss.

Vertical gastric sleeve surgery is a minimally invasive surgery in which the stomach pouch is converted into a sleeve or banana shape. It is a restrictive procedure which brings about changes in the hunger hormone ghrelin thereby inducing , the procedure prompts hormonal changes that assist with weight loss. These same hormonal changes also help relieve conditions associated with being overweight, such as high blood pressure or heart disease.

ideally if a doctor advices Bariatric surgery that means that the doctor themselves feel that no other treatment will be good enough to bring about a significant amount of weight loss and such advice should be considered thoughtfully. Some of the factors that makes Asians or Indians the right candidate for bariatric surgery are: BMI ≥ 32.5 with or without co-morbidities or BMI ≥ 28.5 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
Also, Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts like gym, diet, medicines, etc.

Bariatric Suregry now with the advancement in science and technology can be done lmost like a day-care procedure. The patient ideally walks to the Operation Theatre and walks back to the room post surgery. Recovery period could be about a few hours and a person can get back to a normal routine is a day or two. Apart from dietary restrictions for a couple of weeks, the patient in fact gets back to normal routine and is up and about in no time.

Advances in devices that coagulate blood during surgery, mechanical suturing devices, other mechanical devices and advances in anaesthesia have practically made the surgeries in the present era bloodless.
We at Laparo Obeso Centre use the most advanced and latest devices, equipment and measures to keep the surgery almost bloodless. Many surgeons have specially commented on this while we relayed live surgeries across various countries. It is important to choose an accredited and certified centre with vast experience in that speciality. Results and outcomes of surgeries in such centres are known to be better.

Inguinal Hernia is the protrusion of the abdominal contents through a weakness or defect in the muscles of the groin. Generally, the closure of the defect needs to be done with a permanently strengthening substance, the most commonly used being a synthetic mesh. Only in the paediatric age group, known as congenital hernia, the hernia repair can be done with the closure of defects without a mesh.
Since the surgery is performed only in the inguinal region or the groin area and is mainly focused on the muscle layers, this could be done either key-hole, laparoscopic or open.
Open surgeries are performed with a 3-D Mesh which does not require suture or fixation. Both the types of repair are almost a daycare procedure and patients can resume normal activities from the next day. If the hernia is not treated it keeps on growing in size and can further weaken the muscles and enlarge the defect. Sometimes even intestines can get stuck in the hernia, which is called obstruction. If the intestine is stuck, it can swell, can become gangrenous and become life-threatening.

The standard, recent guidelines for weight loss surgery state that weight loss surgery can be offered after the age of 15 years when most of the overall growth is complete. There could still be some exceptions in children below the age of 15 if they develop chronic life-threatening diseases like diabetes at an early age. However, Paediatric Bariatric Surgeries are best performed at high volume centres or centres of excellence. In the older age group, the medical fitness by a cardiologist and anaesthetist is the parameter based on which the decision is taken. Even patients who have had angioplasty or heart bypass surgery can safely undergo Bariatric Surgery, as after surgery, the weight loss reduces the excess load on the heart, improves co-morbidities like diabetes, high cholesterol, blood pressure all of which eventually prolong the life of the heart surgeries.

Obesity gives rise to issues in quality of life from comorbidities i.e. problem-related diseases up to restrictions in physical activities and appearance of the person suffering from the obesity problem. Bariatric surgery also referred to as weight-loss surgery, can help to resolve this in a faster and safer manner. The surgery involves making changes in the stomach and intestine. The cost of the treatment varies as per personalized treatment depending on the patient’s existing health condition and the treatment modalities. Cost varies depending on the pre-surgical evaluation, which is related to patients' existing conditions related to obesity such as diabetes, metabolic syndrome, hypertension, high blood pressure, etc. More importantly, the cost depends on the patient’s choice of hospital. Patients should choose the best hospital or the treatment center by looking at important aspects such as the experience of the surgical team and the quality of infrastructure. The treatment modalities of the surgery have been evolved and the costs of these treatments are made affordable for a common man using EMIs facility. Also, the patient needs to understand own expenditure made in the long-term over the obese condition and compare it with the estimated cost of the surgery. This cost calculation should include the expected number of years of spending multiplied by per month cost of food, prescriptions, out-of-pocket health expenses, weight-loss programs, etc. And you would find that the cost of surgery is worth it. In India, the approximate cost of bariatric surgery is from 2.5lacs to 7.5 lacs.

Yes, bariatric weight loss surgery is insured in India.
More than 135 million Indians are affected by Obesity, including children. India’s obesity rate is the third-highest in the world and the country has become the capital of Diabetes of the world. As per the latest guidelines of IRDAI (Insurance Regulatory and Development Authority of India), bariatric or weight loss surgery will be included under health insurance cover, effective from 1st October 2019, offering relief to morbidly obese people suffering from obesity. This will help lakhs of patients in India who cannot afford the treatment, that is spread 8-38% in rural areas and 15-30% in urban areas.
Currently bariatric surgery is the only intervention that provides significant and long-term weight loss for the morbidly obese people. It also improves their diabetes, hypertension, and quality of life. The IRDAI’s recent move in Oct. 2019, will provide benefit to a lot of insured patients in the country, who were not able to opt for the surgery due to the cost factor. Also, the treatment modalities of the surgery have been evolved and the costs of these treatments are made affordable for a common man using EMIs facility as well.

Yes, bariatric surgery is a safe, long-term, and effective treatment. Any surgical procedure has its risks, while bariatric surgery is one of the safest surgeries to undergo. When compared to other optional surgeries, it is considered as safe or safer options. The bariatric surgery procedures which employ a laparoscopic approach, such as Vertical sleeve gastrectomy and roux-en-y gastric bypass, reduce the risks of complications.The laparoscopic surgical procedure uses a thin tube called a laparoscope which is inserted into the abdomen through the smallest possible incision. This minimally invasive technique uses tiny cameras and thin tools. This approach cuts down the recovery time, hospital stay, postoperative pain and, limit scarring. Often, experienced surgeons have improved outcomes and a reduced possibility for surgical complications.

You can lose weight quickly by undergoing weight loss surgery if advised by your doctor. The person loses 8-20 kgs in the 1st month and 4-10 kgs / a month, thereafter depending on initial weight. Weight loss continues for 1 1/2 to 2 years till one reaches near-ideal weight and slows down gradually. The results of each individual are different and may not be compared. You may be advised by your doctor to consider weight loss surgery if your body mass index (BMI) is 27 or higher and you are facing trouble with comorbidities such as diabetes, or in case your BMI is 30 or higher with no risk factors. Your medical history and your attempts to lose weight will also be considered.
For example, the patients on insulin having a prominent belly with uncontrollable diabetes, need to lose weight to gain control of diabetes. Unfortunately, medicines don't work for all of them with diabetes making them helpless. Metabolic surgery which is the fastest way to lose weight can be the last scientific solution of weight-loss for those unfortunate ones.
Weight-loss surgery is a boon for people whose nerve sensation is disappearing, sexual and kidney function is deteriorating, patients with higher cardiac risk or if medicines and prolonged diet have failed to show the desired result. Diabetes surgery guidelines state that those with Type II diabetes who are prone to chronic life-threatening diseases and uncontrolled with a BMI of more than 28 kg/m2 may consider this option.

Obesity treatment – If you have followed all the tips mentioned below and have not gained any effect, you can consult the doctor and undergo appropriate surgical or non-surgical obesity treatment advised by the doctor.
Balanced Diet – What do you eat from breakfast to dinner is very important. A balanced diet should include proteins. Breakfast should surely be included with various pulses and eggs. Lunch should be lighter. It should have fewer calories. But, it should have nutritious ingredients. It should include leafy vegetables and fruits. Maintain good levels of Omega-3 Fatty Acid by consuming flaxseeds, fish, nuts, olive oil. Replace carbs the diet with monounsaturated fats like olives, avocados, etc. Consume iodized salt. Keep the intake of vitamin D. Eat well-cooked food. Consume Zinc-rich food such as oysters and pumpkin seeds. Consume food enriched with fiber such as whole grains.
Drink sufficient water – Drink 3 to 5 liters of water every day. Drink sufficient water throughout the day to keep the body hydrated. Drink a glass of water 20 to 30 minutes before meals.
Eat fresh food – Diet should necessarily include fresh food. Fresh food should be eaten and that too preferably hot. Outside food ordered online or that from the food joints we personally purchase is usually not prepared in front of our eyes. Also, such food cools down by the time it reaches home.
Avoid this – Oil, fast-food, junk-food, online-food, sugar, all this should be avoided. All cold drinks should be avoided. This includes fruit juices also. Avoid alcohol, late-night snacking, aerated, and artificially sweetened drinks. Limit consumption of grains.
Regular exercise – Doing regular exercise or Yoga is a very effective way to achieve weight loss. Breathing exercises are also effective. Limit starchy food to smaller portions directly after exercise. Performing intense exercise and interval training is very effective.
Take proper sleep – A sound sleep 8 hours should be taken daily. For this, avoid or release stress and anxiety by doing meditation or by spending quality time with family and friends.

Weight loss surgeries are known as metabolic & bariatric surgery since these procedures correct the metabolism through various hormonal actions. Since the procedures involve change in the anatomy or Size of the stomach as well as passage through intestines, diet after bariatric surgery remains a different science. It is also the same as diet after many GI surgeries so far as nutrition is concerned.

Many patients who have excess craving for food remain apprehensive about whether they would be able to follow the diet instructions after weight loss surgery. Weight loss surgeries effect on the hormones secreted by the stomach & intestines. The level of hunger hormone secreted by the curvature of stomach (known as and ghrelin) comes down, some of the appetite suppressing hormones like GLP1 increase. The combined effect results drastic reduction of excess craving and increase in satiety. The patients who undergo bariatric surgery feel as if some switch in the brain has been switched off. Hence, the patients find it much easier to follow diet after bariatric surgery.

One can practically eat everything after bariatric surgery but obviously in moderation. Occasional intake of any kind of food is acceptable but with the awareness about how to balance the total calories and how the preparations can be made healthier. Bariatric nutritionist is a specialist who teaches the patients about these requirements.

Each person eats till he or she feels full. The amount of food consumed varies in people and is based on the signals of satiety. These satiety hormones after bariatric surgery give complete satiety as if one has had a complete meal. Certain hormones are reduced e.g. ghrelin or hunger hormone levels are reduced after weight loss surgery and levels of certain hormones which offer satiety are increased e.g. GLP1 and PYY. All these hormones directly send a message to the area in the brain which give you satisfaction of eating.

Ideally a person should restrict to three or four meals a day. However, fluid intake has to be frequent. At times, if the hunger is more, a person can eat more frequently and choose nutritious options.

1.Initial or immediate postoperative phase is for first 10 days during which the diet consists of clear liquids. Thicker liquids may be permitted after certain bypass procedures.
2.Second phase is from third week to fourth week. The person is encouraged to consume thick liquids or pureed food or soft food. The average fluid intake has to be maintained.
Various tasty and healthy options or recipes may be suggested during this phase.
3.Third phase is after one month, during which the person is permitted to resume normal diet but with a slow progression and in smaller amounts. Patients are taught about the portion size, need for chewing properly. Liquids should be consumed about half hour prior or after the meals.
4.The forth phase is resuming normal diet and up to one to two years after surgery.
5.The fifth and the last phase is of long term maintenance phase and is equally important. Regular follow up, nutritional evaluation is important. When needed, medications for control of weight gain should be started in time and continued.

It is a common fear among people that eating less may induce weakness. However, if adequate hydration is maintained, a person can easily remain energetic as we see during religious fasting. However, after bariatric surgery, the metabolism starts getting restored to normal and fat starts getting converted into energy. In fact, patients feel lighter and much more energetic after surgery.

In normal weight patients or patients who are slightly overweight eating less may help. But in people who are obese even though people hope that eating less without surgery may treat obesity, it is found to be a myth. Weight gain or weight loss depends on various factors like hormones, genetics, habits, lifestyle, heredity etc. Eating less would be one of the ways of losing weight but if this form of treatment is continued for life long or a couple of years only then it will work. It is important to note that losing weight with diet may be feasible but maintaining a diet for long durations is almost impossible. Hence one needs to look at treatments that are sustainable and possible for a person to follow lifelong. For example, if someone who's BMI is over 35 kg/m2 (morbid obesity) even with a diet as low as 500 calories may not work if the metabolism doesn’t support hence in such patients in spite of strictly following the diet, maintenance may be almost impossible.

Obesity is a much more complex disease than just the consumption of food. There are a lot of patients who eat very little yet are overweight or obese and there are also people who eat a lot and yet remain very thin. This is because each ones genetics, heredity, lifestyle etc vary. In obese people the metabolism is affected whereby in spite of eating less the hormones help maintain a homeostasis i.e., if one eats less the expenditure of calories will also be much lesser in order to maintain that balance. In such patients the stomach, intestines, and the digestive system play a major role in secreting these hormones and controlling one’s hunger, satiety, energy expenditure, and eventually the weight. Such patients with slower metabolism can be treated by a procedure which can normalize their metabolism. Bariatric and metabolic surgeries are keyhole and day-care procedures that can correct the metabolism as well as hormones and induce weight loss which can be reasonably maintained for many years.

Most often nutritional deficiencies exist in all patients overtime. It is only when one is investigated and tested that one knows that there are deficiencies. Any procedure on the stomach or intestine can have an additional impact on nutritional absorption in such situations post surgery supplements which otherwise would have also been required need to be given to patients. The ideal correction is achieved through the sources from diet and with additional supplements. Supplements after weight loss surgery are different from routine.

Actual fact is everyone should follow diet guidelines for life to remain healthy and prevent certain diseases. After weight loss surgery,all foods can be consumed in moderation. But one also needs to remember that if obesity is genetic or heredity and along with that if one is not able to maintain a healthy lifestyle i.e., eating junk food every day, daily consumption of alcohol and sweets or sugary food and no physical activity can slowly become harmful. Hence lifestyle changes are important post surgery and one need not follow a diet for lifelong.

Weight gain post surgery once a person gets back to their normal diet is not as much as compared to pre-operatively. One generally eats everything after surgery but volume and type of food needs to be understood by the patient. Bariatric nutritionist is a specialist who teaches the patients about these requirements after bariatric surgery. If any patient feels that there is weight gain or the hunger/cravings of a person are increasing, in such cases a follow-up with the team is essential to evaluate the reasons and also to provide solutions which are much easier to follow post bariatric surgery as the hormones now support these methods.

Protein supplements are essential even if one can consume them through normal diet as high protein diets tend to be higher in the fat content as well. When one wishes to lose weight it is essential to not just consume good protein sources but to cut down on the fat and high calorie sources as well, hence protein supplements are a good source of rich protein and low/no fat options. Post Bariatric surgery the anatomy and physiology changes thereby changing the pH and absorption hence protein supplements are essential as they are better absorbed and have higher bioavailability as compared to natural dietary protein sources.

The type of procedure one can undergo depends on multiple factors like their age, BMI, co-morbidites.
This decision can be taken by the surgeon, multidisciplinary team and patient in unison.
Sleeve Gastrectomy is only on the stomach and there is no malabsorption of fat. Hence the requirement of multivitamins life long is less.
In a Gastric Bypass procedure a small pouch of the stomach is created and the intestine is connected to it. There is malabsorption of fat that happens but all types of Bypass patients require life long multivitamins as there is malabsorption.
Patients with Haitus Hernia, Reflux disease and long standing diabetes on insulin can benefit with this procedure.
Lap Band procedure is now a banned procedure and is almost not performed.

Diet after Bariatric surgery comprises slow progression from liquids to soft foods and then normal diet. But the biggest plus point is that hunger and cravings almost zero and compliance to the diet is very easy.
These diet phases are for the healing after surgery and are like that which a patient follows after any surgery involving the stomach or intestine.
Even though the volume at a time is less initially, the volume increases reasonably over time with an increase in the stomach size over a few months to years. Inspite of the less volume satiety is the same thereby giving significant satisfaction even with less volume.

Bariatric Surgery works for long term weightloss as it helps in correcting the root cause and treating the metabolism of the patient. The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity

Over weight and obesity both can have a significant impact on a childs health and psychology. High blood pressure, diabets at a young age, breathlessness, asthama, snoring, high cholestrol levels at a very young age are some of the major health problems that could be harmful for the child's health. Similarly, lack of confidence, low self esteem, depression, inability to concentrate can be some of the psychological problems that affect the child along with the health problems. Treatment from a young age will help such children as they grow older. Obesity needs to be looked as a disease rather than just a cosmetic concern. Certain hormonal impact of obesity can remain and hamper even in adulthood. Hormonal changes can give rise to hypogonadism, breast development in young males, excess hair growth, irrgular menstrual cycle and PCOD in females. If not corrected at a young age these problems can be carried into adulthood and affect after life.

Advantages: People who see you daily, will compliment you and you will discover an all new version of yourself that you never could imagine.The Stamina increases drastically, Confidence improves significantly. Apart from these asthetic changes that occur, one will not only lose weight but also have a significant change in their health and co-morbidities that come along with obesity like diabetes, high blood pressure, PCOD, Joint pain, heart health etc. Some of the disadvantages to name a few are, Gastric Bypass being a malabsorptive procedure one will have to be on Multivitamin supplements life long, but generally they can be provided in the form of drinks, chewable sweets hence one may not feel like they are on medications and yet get the same benifits.Any weight loss treatment can lead to some thinning or loss of hair in the first few months after bariatric surgery. This is mainly temporary and will imrpove with time, only regular followups and medications need to be followed for the same.

Weight lost during preperation is genreally with Very Low Calorie diet, medications and supervised preperation. This preperation is strictly done and after all investigations and the surgery date is tentatively decided. This perperation is ONLY for that short durtion and can have other medical implications if continued for longer duration. Medications and diet both become ineffective after a point as the metabolism tries to compensate and bring back the weight. It is almost impossible for anyone to follow such a low calorie diet life long, and it is only when the diet is followed for life long can a person lose and maintain the weight for such long duration.

Advantages: People who see you daily, will compliment you and you will discover an all new version of yourself that you never could imagine.The Stamina increases drastically, Confidence improves significantly. Apart from these asthetic changes that occur, one will not only lose weight but also have a significant change in their health and co-morbidities that come along with obesity like diabetes, high blood pressure, PCOD, Joint pain, heart health etc. Some of the disadvantages to name a few are, Gastric Bypass being a malabsorptive procedure one will have to be on Multivitamin supplements life long, but generally they can be provided in the form of drinks, chewable sweets hence one may not feel like they are on medications and yet get the same benifits.Any weight loss treatment can lead to some thinning or loss of hair in the first few months after bariatric surgery. This is mainly temporary and will imrpove with time, only regular followups and medications need to be followed for the same.

Results of gastric bypass or sleeve gastrectomy or different types of gastric bypass between 1 to 5 years are almost the same and weight loss maintenance is more important in the long run. It is extremely important to know the size of food one should consume at one time and maintain that portion size in the long run to ensure that the weight and the benefits are maintained in the long term. It is not important as to how much you eat but it is important to know what you eat whether the composition suits your body's metabolism. however In a sleeve gastrectomy there is a pyloric valve even intake of liquids could be restricted all types of intake could restricted because of the valve which proves beneficial to the patients. In a gastric bypass because the stomach is connected to the intestine without a valve the passage of food could be easier however it should not be taken as an option to eat more. What is more important is to get satisfaction of eating and getting a sensation that you have eaten enough and you have enjoyed everything which just possible after any type of bariatric surgery. However diet protocols could be based on BMI, metabolism, expected target of weight loss, patients age, health and multiple such factors. Consulting a bariatric nutritionist in a center of excellence is ideal way to know understand how much should be by a patient after bariatric surgery.

Bariatric surgery is a surgery performed either on the stomach or the intestine. the stomach size is reduced in such a way that the hunger hormones reduce and therefore the cravings significantly reduced. Patient can maintain himself or herself by eating smaller portions of food and at the same time getting the satisfaction of a full meal because there is satiety. The hormones in the intestine also stimulate the centre for metabolism, reduce hunger, improve utiliztion of fat and conversion into energy. Because these are hormonal actions and the intake becomes less through actions on the brain and hypothalamus. The results are maintained over long term. There could be variability in the results of weight loss in different individuals as this is based on genetics and how early the person takes the decision to take treatment. Those who are called super obese may need to work more aggressively to improve their weight loss to the maximum. Genreally hypertension, daibetes are resolved after surgery, the pain reduces, and patient becomes more active. Hoever remianing active, learning nutrition from the bariatric nutritionist is very important to achieve and maintain the weight loss. Bariatric suregry is a tool to induce wieght loss and everyone need to learn lifestyle change, regular followup and guidelines is the key to success and anyone who follows this will be sure to get a good result post bariatric surgery.

Hypertension or high blood pressure occurs when the force with which the blood pushing against the artery wall is too high. Any blood pressure above a mark of 140/90 is called blood pressure and above 180/120 is called severe. The significant rise in obesity is found to have a direct correlation to risk of high blood pressure. Obesity and hypertension together can give rise to an array of health issues and challenges there by affecting health, quality of life and life expectancy. Apart from just weight and obesity the fat distribution is also an important factor that plays a major role. Abdominal Obesity or central obesity around the waist circumference is the influencing factor for developing hypertension. A BMI above 30 is a major risk factor for high blood pressure. When a person is overweight or obese, the heart has to work harder to pump blood throughout the body. This puts an excess stress on the arteries which in turn makes the arteries to resist this flow causing the blood pressure to rise.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. However some patients with malabsorptive procedure may have to focus more on micro nutrient supplementation, a regular followup, a regular blood workup is mandatory to minimize any hazards related to the procedures. In case there are any complications the patient should seek help from experts and senior surgeons who has practice of more than 10 years with Bariatric procedure.

Change in skin due to weightloss depends on the persons age, BMI, Health realted problems, weight loss attempts. The skin has a natural tendencay to fully stretch and come back to its normal texture 2-3 times. Generally for females that chance is lost during pregnancy. And apart from that if there are any weight loss attempts the skin gets stretched again. Hence a weight loss treatment not only requires to be life long but also adequate with nutrition and vitamins for beautification and skin.

Type 2 Diabetes is invariably in majority of the patients with some grade of obesity or some excess fat in the body. Fat is known to increase insulin resistance and losing that fat can improve insulin resisctance. However for reversal of diabetes, significant weight loss ie., almost 70% of excess weight loss and mainintaing that lost weight for long term is needed. Recently there are papers published on reversal of diabetes with Very Low Calorie Diet ie., only 600-800calories per day for 3 months. However feasibility of such a low calorie diet is questionable and that is why it is not widely practiced in clinical practice. However weight loss through metabolic surgery for diabetes is known to induce significant weight loss as well as add other hormonal mechanisms that reverse diabetes. and hence reversal of diabetes through metabolic surgery for diabetes and related weight loss is recommended in the guidelines of diabetes treatment by multiple diabetes organizations in the world.

Results of gastric bypass or sleeve gastrectomy or different types of gastric bypass between 1 to 5 years are almost the same and weight loss maintenance is more important in the long run. It is extremely important to know the size of food one should consume at one time and maintain that portion size in the long run to ensure that the weight and the benefits are maintained in the long term. It is not important as to how much you eat but it is important to know what you eat whether the composition suits your body's metabolism. however In a sleeve gastrectomy there is a pyloric valve even intake of liquids could be restricted all types of intake could restricted because of the valve which proves beneficial to the patients. In a gastric bypass because the stomach is connected to the intestine without a valve the passage of food could be easier however it should not be taken as an option to eat more. What is more important is to get satisfaction of eating and getting a sensation that you have eaten enough and you have enjoyed everything which just possible after any type of bariatric surgery. However diet protocols could be based on BMI, metabolism, expected target of weight loss, patients age, health and multiple such factors. Consulting a bariatric nutritionist in a center of excellence is ideal way to know understand how much should be by a patient after bariatric surgery.

Obesity and overweight are linked to several factors that increase ones risk for cardiovascular disease. It can change your cholesterol levels. It can cause the bad cholesterol and triglyceride levels to rise, thereby increasing the risk for heart disease.
It can cause your blood pressure to rise. Obese individuals require more blood to supply oxygen and nutrients to their bodies which causes an increase in blood pressure. Your body will also require more pressure to move this blood around. High blood pressure is also a common cause of heart attack especially in obese individuals.
Obesity can also lead to diabetes. Obese individuals also have a much greater chance of developing diabetes. Multiple studies show people aged 65 or older with diabetes also have heart disease. While individuals with diabetes are said to be two to four times more likely to be at risk for heart disease, diabetes is one of the top seven major controllable factors to prevent heart disease. If you have diabetes but have yet to be diagnosed with heart disease. Thus treatment that improves not just obesity but also treats diabetes and heart health are most efficient forms of treatment.

Carbonated drinks have an effervescence which can give rise to bubbles and lead to expansion. Carbonated drinks can also empty the pouch rapidly. There is no absolute no for any such drink, however drinking it frequently can increase the pouch size or give one more frequency of hunger. Drinks like flavoured water, lime water etc are more beneficial.

Vertical gastric sleeve surgery is a minimally invasive surgery in which the stomach pouch is converted into a sleeve or banana shape. It is a restrictive procedure which brings about changes in the hunger hormone ghrelin thereby inducing , the procedure prompts hormonal changes that assist with weight loss. These same hormonal changes also help relieve conditions associated with being overweight, such as high blood pressure or heart disease.

Diet post Bariatric Surgery is as per the American Society's guidelines after surgery. The first 10 days after surgery is clear liquid diet, which is then switched to thicker pureed food and then the patient is then shifted to a near normal diet in 1-2 months. Bariatric Nutritionists usually design a diet composition which is healthy and nutritious for the patient.

People having Bariatric surgery always enjoy the phases of weight loss, change in confidence, change in their clothes size, new shopping etc. Most of their co-morbidities like diabetes, blood pressure, joint pain, resolve. However there is less intake, patients need to focus on multivitamins and have regular follow-up. Of course , lifestyle change is always a challenge for everyone, however the team will always teach them how to change and improve their lifestyle. Some times they have to work on improving their skin tone by exercise, massage, nutrition, vitamins, and some times if neeeded some patients may even need an asthetic correction after bariatric procedure. The most important challenge is longterm maintainence of the lost weight after the bariatric procedure and no one wants to lose it. There are medications to improve metabolism which can be started a few years after bariatric surgery that can help with weight maintenance over a long period. Incidence of Gallstone formation after any weight loss treatment are know. After Bariatric surgery there are medications for prevention of Gallbladder stones. However, a person needs to follow by ultra sonography to check on the gall stone formation one a year.

In general most of the sugar substitutes are not healthy Are not the healthiest choice for an individual however certain sugar substitutes like stevia and sucralose in permitted daily doses good proof less harmful than normal sugar inpatients with obesity and diabetes. Sugar substitutes are of different types and every label should be red and understood to see which substitute is offered in this. Generally bariatric physicians or surgeons recommend that sugar free sweets or anything with a label of sugar free may have certain sugar substitute which is not recommended and those options or sweets from over the counter purchase should specifically be avoided by diabetic patients. Natural substances like dates would be a healthier option for a patient with diabetes. In case there are extreme cravings then instead of finding a substitute one should see a doctor and his team who can offer certain medications.

There are different approaches for weight loss like diets, physical activity, pharmacotherapy, Endoscopic treatment, weight loss surgeries. The best treatment depends on right approach at right time depending upon age, height, weight, BMI and co morbidities, past attempts of weight loss. Ideally the best attempt is ideal diet and physical activity to prevent weight gain. Choice of therapy can be based on various factors like Body fat percentage, Body mass index, Evaluation of diseases directly induced by obesity, Psychology impact if any and Evaluation of long term risks.

No, gastric bypass surgery does not shorten life. In fact Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accredited centre the risks become minimum, provided all the clinical protocols are being followed. However some patients with mal-absorptive procedure may have to focus more on micro nutrient supplementation, a regular followup, a regular blood workup is mandatory to minimize any hazards related to the procedures. In case there are any complications the patient should seek help from experts and senior surgeons who has practice of more than 10 years with Bariatric procedure.
Advantages: People who see you daily, will compliment you and you will discover an all new version of yourself that you never could imagine.The Stamina increases drastically, Confidence improves significantly. Apart from these asthetic changes that occur, one will not only lose weight but also have a significant change in their health and co-morbidities that come along with obesity like diabetes, high blood pressure, PCOD, Joint pain, heart health etc. Some of the disadvantages to name a few are, Gastric Bypass being a malabsorptive procedure one will have to be on Multivitamin supplements life long, but generally they can be provided in the form of drinks, chewable sweets hence one may not feel like they are on medications and yet get the same benifits.Any weight loss treatment can lead to some thinning or loss of hair in the first few months after bariatric surgery. This is mainly temporary and will imrpove with time, only regular followups and medications need to be followed for the same.

Gastric bypass surgery is known as gold standard of bariatric surgery and is being performed for more than 4 decades.The procedure has strong diabetic and reverses diabetes. The procedure has restriction in form of small pouch and malabsorption of fat and therefore the weight loss results published in long term are excellent. Because the gastric pouch is small and is a malabsorptive procedure patients needs vitamins , minerals and protein supplements for lifetimeGastric Bypass surgery is a laparoscopic or a keyhole day care procedure in which laparoscopically stomach is converted into a small pouch and a Y shaped intestine is connected to the stomach pouch. Patient can start walking 3 to 4 hours after surgery and started on clear liquid after about 4 to 6 hours after surgery. Once the patient is well hydrated the patient can be discharged. Gastric bypass surgery is the best procedure for reversal of obesity and type 2 diabetes.

If a patient is not operated, one must follow fat free diet as the fatty, oily food stimulates the gall bladder and can cause the digestive enzymes to push the gall stone or the gravel to go down with it.
In case the stone is big in size it may get stuck and block the passage of bile and digestive enzymes there by causing severe pain and jaundice. Hence diet must be fat free, not too spicy or sugary.

A gall bladder that has stones in it is generally an infected one and needs removal. Sharp pain in the right side of abdomen radiating to the back, pain after meals, nausea, Vomiting, acidity, fever and raised liver enzymes are signs of alarm and need immediate attention.
If the gall bladder stones get lodged in the bile duct it can lead to blockage of the bile thereby leading to obstruction and there by jaundice.
Thus, removal of the gall bladder is essential and emergency.
A few people may incidentally find gall bladder stones but if no complaints surgery may be delayed.

Anyone BMI falls between 25 and 29.9, you are overweight. If your BMI is 30 or higher, you are considered obese. However, you may have an excess fat percentage in your body even though the total weight looks less. If this excess fat is causing diseases like diabetes, hypertension, psychological discomfort and resistant to medical treatment, you may be a candidate for metabolic treatment.
Anyone above an excess of 20kg weight will ideally benefit from Bariatric or metabolic surgery as scientifically that will help with weight loss. The type of procedure one undergoes will depend on the co-morbidities, history, habits, lifestyle.
This decision will be made by the patient, surgeon and multidisciplinary team.

Yes. All regular fat free and soft diets can be consumed after gallbladder surgery.

The scientific way of losing weight is by restricting diet, improving physical activity, and adding some treatment like medications. Generally this kind of weight is lost in very huge patients where excess weight loss is very high only after Bariatric Surgery. The treatment has to be based on a person's BMI, total excess weight, lifestyle, genetics and an ideal obesity centre should design the weight loss treatment for the patient. There are different approaches for weight loss like diets, physical activity, pharmacotherapy, Endoscopic treatment, weight loss surgeries. The best treatment depends on right approach at right time depending upon age, height, weight, BMI and co morbidities, past attempts of weight loss. Ideally the best attempt is ideal diet and physical activity to prevent weight gain. Choice of therapy can be based on various factors like Body fat percentage, Body mass index, Evaluation of diseases directly induced by obesity, Psychology impact if any and Evaluation of long term risks

Gallbladder surgery needs advanced equipment, vessel sealing devices and advanced endovision systems. LOC healthcare LLP or Laparo Obeso Centre has been rated as the best hospital for Laparoscopic surgeries including laparoscopic gallbladder surgeries. These surgeries are often performed without stitch and as a day care procedure. The surgical team has an experience of over 30 years for performing such procedures along with more complex procedures.

Gall bladder removal surgery or Cholecystectomy is a standardised procedure that is approved by all insurance companies. The cost of the surgery varies depending on open or laparoscopic surgery. The cost is standardised and covered under cashless as well as reimbursement

In fact anyone who is of normal weight and BMI may lose some weight after gallbladder surgery as the patient is put on a fat free, oil free and less sugary diet which will in fact aid weight loss.
One of the reasons for developing gallbladder stones is multiple weight loss attempts that are unscientific. And such people generally have a higher BMIs and may benefit from bariatric/metabolic surgery.

Any form of rapid weight loss or unsupervised sudden weight loss can be a major reason for developing gallbladder stones. During weight loss attempts, long hours of fasting the liver produces extra cholesterol into bile. This thereby prevents the emptying of the gallbladder and thus risking stone formation. Getting treated at a centre that scientifically provides treatment and looks into all these factors and provides treatment is the right treatment.

Ideally it is advised to consume a fat free diet after gallbladder removal surgery. The bile now secreted directly goes into the intestine which can act as a laxative and give rise to Diarrhoea. Ideally, post a gallbladder removal surgery the patient is advised to change from Liquid diet to soft/pureed food and then regular diet. The diet should initially be fat free, non-spicy and non-sugary.

It is not impossible to lose weight after gallbladder surgery. In fact anyone who is of normal weight and BMI may lose some weight after gallbladder surgery as the patient is put on a fat free, oil free and less sugary diet which will in fact aid weight loss. But if someone is gaining weight then such patients may have a challenge and consult a team of experts who will identify reasons for weight gain, identify co-morbidities and advise treatment accordingly. If BMI is over 32kg/m2 then such patients have a diseased metabolism and may not benefit from diet and exercise and may require metabolic and bariatric surgery.

Meat though a good form of protein can be a good option for patients. But the cooking style is essential as most often than not Indian preparations use oil and fat sources to cook it. Giving up on meat is also not a factor that will make one lose weight. One needs to not just focus on losing weight but maintaining that weight is also equally important. One should ideally follow a low-carb, low fat and rich in protein diet plan. But an ideal diet plan will depend on the patient's weight, health, co-morbidities and should be planned by a qualified weight loss expert and nutritionist.

Type 2 Diabetes is invariably in majority of the patients with some grade of obesity or some excess fat in the body. Fat is known to increase insulin resistance and losing that fat can improve insulin resistance. However for reversal of diabetes, significant weight loss ie., almost 70% of excess weight loss and maintaining that lost weight for long term is needed. Recently there are papers published on reversal of diabetes with Very Low Calorie Diet ie., only 600-800calories per day for 3 months. However feasibility of such a low calorie diet is questionable and that is why it is not widely practised in clinical practice. However weight loss through metabolic surgery for diabetes is known to induce significant weight loss as well as add other hormonal mechanisms that reverse diabetes. and hence reversal of diabetes through metabolic surgery for diabetes and related weight loss is recommended in the guidelines of diabetes treatment by multiple diabetes organisations in the world.

Type 2 Diabetes is invariably in the majority of the patients with some grade of obesity or some excess fat in the body. Fat is known to increase insulin resistance and losing that fat can improve insulin resistance. However for reversal of diabetes, significant weight loss ie., almost 70% of excess weight loss and maintaining that lost weight for long term is needed. However weight loss through metabolic surgery for diabetes is known to induce significant weight loss as well as add other hormonal mechanisms that reverse diabetes. and hence reversal of diabetes through metabolic surgery for diabetes and related weight loss is recommended in the guidelines of diabetes treatment by multiple diabetes organisations in the world.

Gallbladder surgery needs advanced equipment, vessel sealing devices and advanced endovision systems.These surgeries are often performed without stitch and as a day care procedure. A surgical team with an experience and expertise for performing complex procedures is essential

Obesity can induce sexual dysfunction in a male or female due to various reasons. Some of most simple reasons are: severe joint pain, breathlessness on lying down, backache, in males, in-drawing of the genital organs due to excess fat deposition as well as diabetes, high blood pressure, snoring etc all of which further reduce sexual functioning. Obesity also induces certain hormonal changes because of which sexual libido are suppressed. Poor confidence, body image issues and poor self esteem as well as depression can aggravate these further.
How does obesity induce sexual dysfunction in a female?
Fat is known as an endocrine organ and in a female with obesity it can convert female hormone into male hormone (androgenic environment). This can be seen as excess hair growth on the face, pimples, or black discoloration which continues to increase. At the same time excess belly fat or excess fat deposition can have in drawing of the genital organs, bodily pain, back ache can aggravate this and most importantly snoring diabetes and the excess male hormone generated by fat reduce sexual drive, libido reduce her confidence, lead to body image issues in a female and can disturb the quality of sexual life.
How does obesity reduce sexual function or fertility in a male?
Fat in a person with obesity can reduce the testosterone or male hormone levels in a male. Reduction in testosterone can reduce desire for sexual function. Excess fat can give rise to what is called pseudo hypogonadism or in drawing of the genital organ because of excess fat. Even the temperature change in the scrotum can reduce the quality of sperm and reproduction of sperm thereby reducing fertility in a male thus sexual dysfunction is seen both in males and females which is not commonly known to most people

Gallbladder surgery is laparoscopic removal of gallbladder which is disease and has multiple stones. Having multiple stones in the bladder has multiple risks like if the stone slips into the common duct there could be jaundice, if it splits further and get stuck there could be inflammation of pancreas which is called pancreatitis and it can be serious. Long-term gallbladder stones in the gallbladder can have continuous irritation of the gallbladder wall and can even give rise to cancer. Hence gallbladder surgery is performed for gallstone disease and the gallbladder is removed during the procedure. Bile is actually produced in the liver so gallbladder removal does not interfere with digestion or secretion of bile. If the stone slips and gets stuck in the common bile duct then the surgery can be complicated hence treatment at the right time is essential.

Type II diabetes is a complex disorder. Many factors responsible are: genetic tendancy, pancreatic function, sesitivity of muscles to insulin, fat stores in the liver as well as grade of activity and lifestyle. Even though, some patients with morbid obesity do not have diabetes, their pancreas secretes higher level of insulin due to the insulin resistance. Insulin resistance varies from person to person. Hence everyone with morbid obesity does not necessarily get diabetes but may have pre diabetes or weight related co-morbidities and fatty liver disease. At the same time some people woth lesser grade of obesity maty have diabetes. thorough investigations to know the type of diabetes, pancreatic function are necessary since there are many genetic variants of diabetes which appear like type 2 diabetes but they are not.

There are different approaches for weight loss like diets, physical activity, pharmacotherapy, Endoscopic treatment, weight loss surgeries. The best treatment depends on right approach at right time depending upon age, height, weight, BMI and co morbidities, past attempts of weight loss. Ideally the best attempt is ideal diet and physical activity to prevent weight gain. Choice of therapy can be based on various factors like Body fat percentage, Body mass index, Evaluation of diseases directly induced by obesity, Psychology impact if any and Evaluation of long term risks.

It is generally thought that the most effective way to lose weight is to eat less and exercise more. If it works, it would be ideal. However, most often, this may not work for long time. In that case, evaluation of body’s genetics, metabolism and hormones can give us some information about the root cause of the altered metabolism. The decision of further treatment can be based on all the above information as well as results of previous attempts. There are various methods to lose weight which include certain medications, endoscopic balloon insertion and even metabolic surgery at times. Some Life style change will still remain important always.

We believe in a comprehensive weight loss clinic which would offer all options including medical to surgical options. Pure medical weight loss clinics may have a bias of other options and may attempt medical weight loss for everyone. Such medical weight loss clinics have to be collaborated with bariatric surgery clinics since failures in medical weight loss management are high in numbers. Caution for the people with morbid obesity, medical weight loss may not be the best one for them and failed attempt is not a failure of the person or clinician. It justs suggests that scientific guidelines of obesity management can still save you.

The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. A weight management program combines physical activity, diet, behavioral modification, psychological counseling, and sometimes drug therapy to help patients achieve weight loss or prevent further weight gain. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity.

Ideally Bariatric Surgery after preganacy should be planned 3-6 months after the delivery. However there are patient who's BMI is very high and they may have pregnancy induced hypertension, swelling, breathlessness which makes it difficult to take care of the baby. Such patients can undergo surgery at any point of time. The medications for Baraitric Surgery are given only for 24 hours and even lactating mothers can undergo surgery. Bariatric Surgery is intended to make the mother pain-free, mobile, healthy so that she can take care of the baby better. The changes related to pregnancy reverse in about 6 months time. and during this time if the lady does not lose weight and carries the obesity she is eligible to undergo surgery.

The normal adult gallbladder measures from 7-10 cm in length and 3-4 cm in transverse diameter.

A non-invasive surgery is one which is done laparoscopically. There are no cuts or stitches. They are extremely standardized, laparoscopic and endoscopic procedures. These procedures can be done as a day care procedure and the patient is moving about and active in a few hours post surgery. The healing period for the wound is generally 6-8 weeks and the patient can start with walking immediately and can perform all routine activities. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. Results of gastric bypass or sleeve gastrectomy or different types of gastric bypass between 1 to 5 years are almost the same and weight loss maintenance is more important in the long run. It is extremely important to know the size of food one should consume at one time and maintain that portion size in the long run to ensure that the weight and the benefits are maintained in the long term. It is not important as to how much you eat but it is important to know what you eat whether the composition suits your body's metabolism. however In a sleeve gastrectomy there is a pyloric valve even intake of liquids could be restricted all types of intake could restricted because of the valve which proves beneficial to the patients. In a gastric bypass because the stomach is connected to the intestine without a valve the passage of food could be easier however it should not be taken as an option to eat more. What is more important is to get satisfaction of eating and getting a sensation that you have eaten enough and you have enjoyed everything which just possible after any type of bariatric surgery. However diet protocols could be based on BMI, metabolism, expected target of weight loss, patients age, health and multiple such factors. Consulting a bariatric nutritionist in a center of excellence is ideal way to know understand how much should be by a patient after bariatric surgery.

Generally a mothers weight after pregnancy should come back to the ideal weight according to the height +/- 5kgs. If the weight remains the same as during pregnancy then it is not normal. Ideally Bariatric Surgery after pregnancy should be planned 3-6 months after the delivery. However there are patient who's BMI is very high and they may have pregnancy induced hypertension, swelling, breathlessness which makes it difficult to take care of the baby. Such patients can undergo surgery at any point of time. The medications for Baraitric Surgery are given only for 24 hours and even lactating mothers can undergo surgery. Bariatric Surgery is intended to make the mother pain-free, mobile, healthy so that she can take care of the baby better. The changes related to pregnancy reverse in about 6 months time. and during this time if the lady does not lose weight and carries the obesity she is eligible to undergo surgery.

Liposuction is a cosmetic correction treatment and can be done for someone who is 5-8 kgs excess weight. It is ideally not done as a weight loss treatment. In Liposuction the fat under the skin is removed using a suction cannula but nothing is dont to the fat that is on the organs inside. For someone who has more than 10kgs excess weight may not benefit much from liposuction since not much is done to the metabolism and the body will start storing fat again over time and at different places in the body. Treatments that are long term in basically help in changing the body's metabolism from fat storage to fat utilisation would be an ideal treatment to prevent the fat cells from coming back and to get a long term solution to fat. Bariatric Surgery is the ideal most treatment for long term weightloss as it helps in correcting the root cause and treating the metabolism of the patient. The primary goal for managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. Bariatric or Metabolic Surgery is generally reserved for patients who have repeatedly failed to lose weight by all other means (diet, exercise, behavioral, and drug therapy). Surgical treatment is medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. Surgical treatments are now safe, can be performed key-hole and as day-care procedures. Surgical procedures give significant loss of excess weight and can reverse conditions like joint pain, breathlessness, snoring, infertility, sexual dysfunction, urine incontinence, headaches, and migraines, etc. Metabolic and Bariatric Surgery is the only modality that can totally reverse or improve diseases like diabetes, blood pressure, high cholesterol or lipids, kidney dysfunction, osteoarthritis etc which are secondary to obesity

Some of the scientific ways of losing weight are lifestyle modifications ie., diet and exercise, pharmacotherapy and endoscopic, weightloss procedure. The most amount of weight one loses depends on the age, height, weight, BMI, health problems occuring with obesity and the right approach at the right time. There are different approaches for weight loss like diets, physical activity, pharmacotherapy, Endoscopic treatment, weight loss surgeries. Generally, the first line of treatment though is diet and exercise, whether it will work for a patient or not depends on the right approach at right time depending upon age, height, weight, BMI and co morbidities, past attempts of weight loss. Weight loss pills can be effective if combined with diet and exercise and are generally given to someone who ranges between the BMI 25-28kg/m. Any BMI higher than that, the metabolism changes and the person is unable to lose weight or maintain the lost weight with the modality of weight loss pills. In such patients the weightloss pills prove to be ineffective. Hence the treatemnt that one attepmts to follow should be adviced by an experienced team of experts who have adviced such treatments.

Male or Female obesity tends to have the same impact on every individual. Obesity is a disease in itself and it requires life long treatment. Some of the effects of obesity are immediate and some effects occur over time but both significantly affect daily living. Joint pain, Urinary Incontinence due to huge central obesity, sexual dysfuntion, snoring all affect a patients confidence and self esteem. These are changes that occur within a short duration and affect the qualtiy of life, relations and health. Similarly diabets, high blood pressure, heart diseases, and some types of cancer can occur over time when the obesity is long lasting. Thus obesity and its co-occuring health problems do signinficantly affect daily living and qualtiy of life. Infact all national and international obesity and health organiztions have now defined obesity as a disease. And a disease just like obesity affects all areas of life and functioning. It has health implications, psychological implications thereby affecting the qualtiy of life. The health risks associated with obesity are Diabetes, blood pressure, joint pain, sleep apnea or snoring, heart disease, low self esteem and confidence most of which people are unable to correlate with obesity. This inability to correlate can affect a persons perception o obesity as a disease.

The Asian guidelines for overweight or obesity are different from European and American guidelines as Indians have a higher fat percentage as compared to their European and American counterparts.
Being overweight or obese can be calculated by either method of BMI calculation, Waist Circumference, or a more advanced method of Body Fat Percentage with the help of Body composition.
BMI is calculated by kg/m2, where a person's weight in kilograms and m2 is their height in metres squared.
A Normal BMI lies in the range 18-22.9kg/m2, BMI between the range 23-24.9kg/m2 is defined as Overweight, BMI >=25kg/m2 is defined as Obese and any BMI 32.5kg/m2 is defined as Morbidly Obese.
A Waist Circumference >80cms in Females and >90cms in Males is an indication of Obesity
Similarly, any person with a Body Fat Percentage of >20% is defined as Obese and a person with a Body Fat Percentage of >30% is defined as Morbidly Obese
If a person falls under any of the above categories of BMI, Waist Circumference or Body Fat Percentage they are defined as overweight or obese.

Obesity is a disease in itself and it requires life long treatment. Some of the effects of obesity are immediate and some effects occur over time but both significantly affect daily living. Joint pain, Urinary Incontinence due to huge central obesity, sexual dysfuntion, snoring all affect a patients confidence and self esteem. Apart from these Diabetes, high blood pressure, certain types of cancers, heart problems are some of the main consequences of obesity that impact all areas of life and functioning. Hence obesity may not really have any pros or advantage.

Gallbladder surgery is laparoscopic removal of gallbladder which is disease and has multiple stones. Having multiple stones in the bladder has multiple risks like if the stone slips into the common duct there could be jaundice, if it splits further and get stuck there could be inflammation of pancreas which is called pancreatitis and it can be serious. Long-term gallbladder stones in the gallbladder can have continuous irritation of the gallbladder wall and can even give rise to cancer. Hence gallbladder surgery is performed for gallstone disease and the gallbladder is removed during the procedure. Bile is actually produced in the liver so gallbladder removal does not interfere with digestion or secretion of bile. If the stone slips and gets stuck in the common bile duct then the surgery can be complicated hence treatment at the right time is essential. Generally, if surgery for removal of gall bladder is done laparoscopically, it can be done as a day care procedure and the patient is moving about and active in a few hours post surgery. The healing period for the wound is genereally 6-8 weeks and the patient can start with walking immediately but heavy weight training should generally be avoided for a month to 6 weeks so that the wound healing happens well and chances of developing hernia in the abdominal wall.

Ideally it is advised to consume a fat free diet after gallbladder removal surgery. The bile now secreted directly goes into the intestine which can act as a laxative and give rise to Diarrhoea. Ideally, post a gallbladder removal surgery the patient is advised to change from Liquid diet to soft/pureed food and then regular diet. The diet should initially be fat free, non-spicy and non-sugary.

Gall Bladder stones are formed in the gall bladder when the normal functioning of the gall bladder is affected. Gall bladder stones, unlike kidney stones do not pass and can cause serious health problems if not treated well in time. Hence gall bladder removal surgery also called Cholecystectomy is advised even if there are no complaints. Once gall bladder is removed one cannot have stones again.

Gall bladder removal surgery or Cholecystectomy is a standardised procedure. Having multiple stones in the bladder has multiple risks like if the stone slips into the common duct there could be jaundice, if it splits further and get stuck there could be inflammation of pancreas which is called pancreatitis and it can be serious. Long-term gallbladder stones in the gallbladder can have continuous irritation of the gallbladder wall and can even give rise to cancer. Hence gallbladder surgery is performed for gallstone disease and the gallbladder is removed during the procedure. Bile is actually produced in the liver so gallbladder removal does not interfere with digestion or secretion of bile. If the stone slips and gets stuck in the common bile duct then the surgery can be complicated hence treatment at the right time is essential. Generally, if surgery for removal of gall bladder is done laparoscopically, it can be done as a day care procedure and the patient is moving about and active in a few hours post surgery. The healing period for the wound is genereally 6-8 weeks and the patient can start with walking immediately but heavy weight training should generally be avoided for a month to 6 weeks so that the wound healing happens well and chances of developing hernia in the abdominal wall.

One is advised to consume a fat free diet after gallbladder removal surgery. The bile now secreted directly goes into the intestine which can act as a laxative and give rise to Diarrhoea. Ideally, post a gallbladder removal surgery the patient is advised to change from Liquid diet to soft/pureed food and then regular diet. The diet should initially be fat free, non-spicy and non-sugary. Though once the healing period is over one can gradually start eating everything.

Bariatric surgery is an extremely standardized, laparoscopic and endoscopic procedure. If the surgery is performed in a High-Volume, accrediated centre the risks become minimum, provided all the clinical protocols are being followed. Results of gastric bypass or sleeve gastrectomy or different types of gastric bypass between 1 to 5 years are almost the same and weight loss maintenance is more important in the long run. It is extremely important to know the size of food one should consume at one time and maintain that portion size in the long run to ensure that the weight and the benefits are maintained in the long term. It is not important as to how much you eat but it is important to know what you eat whether the composition suits your body's metabolism. however In a sleeve gastrectomy there is a pyloric valve even intake of liquids could be restricted all types of intake could restricted because of the valve which proves beneficial to the patients. In a gastric bypass because the stomach is connected to the intestine without a valve the passage of food could be easier however it should not be taken as an option to eat more. What is more important is to get satisfaction of eating and getting a sensation that you have eaten enough and you have enjoyed everything which just possible after any type of bariatric surgery. However diet protocols could be based on BMI, metabolism, expected target of weight loss, patients age, health and multiple such factors. Consulting a bariatric nutritionist in a center of excellence is ideal way to know understand how much should be by a patient after bariatric surgery.

The type of procedure one can undergo depends on multiple factors like their age, BMI, co-morbidites.
This decision can be taken by the surgeon, multidisciplinary team and patient in unison.
Sleeve Gastrectomy is only on the stomach and there is no malabsorption of fat. Hence the requirement of multivitamins life long is less. In a Gastric Bypass procedure a small pouch of the stomach is created and the intestine is connected to it. There is malabsorption of fat that happens but all types of Bypass patients require life long multivitamins as there is malabsorption. Patients with Haitus Hernia, Reflux disease and long standing diabetes on insulin can benefit with this procedure. Lap Band procedure is now a banned procedure and is almost not performed.

No. unlike kidney stones Gall bladder stones cannot be flushed out and require surgical removal of the gall bladder, also known as cholecystectomy.

Asians are known to have more body fat as compared to westerners and anyone with a weight in excess of 20-22kgs in comparison to their ideal weight which does not respond to medical treatment, quaifies for bairatric surgery. Generally a body mass index of 32kg/m2 with comorbidities is called morbid obesity in asian guidelines and any such patients should be advised bariatric surgery as per the scientific guidelines.The comorbidity status and faiure of medical weight loss are main indication where a decision of bariatric surgery is taken.The comorbidities could be variable for age and based on BMI.For example a young girl may have PCOD,Hirsutism Excess hair growth on face,loss of confidence will have significant psycosocial comorbidities but lab parameter may be normal yet she would qualify for bariatric surgery. The ideal evaluation for bariatric surgery is evalution of hormones,all the systems sonography whenther the patient has pre diabetes or the cholesterol is normal ,the vitamins status and after evalution all of this nutritionist,psychologist, a bariatric physician and a bariatric surgeon would evalute patient for a appropriate type of surgery.After this the patient should be explained the pros and cons and long term maintainence and after understanding all of this the patient should take the desicion of bariatric surgery. The pre op evaluation, the understanding, the long term care are one of the most important aspects of bariatric surgery. Patients who have very large liver, breathing problems may be put on a preperation of low calorie diet for a period of 5-15 days to prepare their liver, induce some weigtloss and keep them prepared and make them lower risk for surgery. any centre that is accrediated and follows the best international guidelines is a centre where the patient should seek bairatric surgery.

Gallbladder surgery is laparoscopic removal of gallbladder which is disease and has multiple stones. Having multiple stones in the bladder has multiple risks like if the stone slips into the common duct there could be jaundice, if it splits further and get stuck there could be inflammation of pancreas which is called pancreatitis and it can be serious. Long-term gallbladder stones in the gallbladder can have continuous irritation of the gallbladder wall and can even give rise to cancer. Hence gallbladder surgery is performed for gallstone disease and the gallbladder is removed during the procedure. Bile is actually produced in the liver so gallbladder removal does not interfere with digestion or secretion of bile.Generally, if surgery for removal of gall bladder is done laparoscopically, it can be done as a day care procedure and the patient is moving about and active in a few hours post surgery.

Obesity can induce sexual dysfunction in a male or female due to various reasons. Some of most simple reasons are: severe joint pain, breathlessness on lying down, backache, in males, in-drawing of the genital organs due to excess fat deposition as well as diabetes, high blood pressure, snoring etc all of which further reduce sexual functioning. Obesity also induces certain hormonal changes because of which sexual libido are suppressed. Poor confidence, body image issues and poor self esteem as well as depression can aggravate these further.
How does obesity induce sexual dysfunction in a female?
Fat is known as an endocrine organ and in a female with obesity it can convert female hormone into male hormone (androgenic environment). This can be seen as excess hair growth on the face, pimples, or black discoloration which continues to increase. At the same time excess belly fat or excess fat deposition can have in drawing of the genital organs, bodily pain, back ache can aggravate this and most importantly snoring diabetes and the excess male hormone generated by fat reduce sexual drive, libido reduce her confidence, lead to body image issues in a female and can disturb the quality of sexual life.
How does obesity reduce sexual function or fertility in a male?
Fat in a person with obesity can reduce the testosterone or male hormone levels in a male. Reduction in testosterone can reduce desire for sexual function. Excess fat can give rise to what is called pseudo hypogonadism or in drawing of the genital organ because of excess fat. Even the temperature change in the scrotum can reduce the quality of sperm and reproduction of sperm thereby reducing fertility in a male thus sexual dysfunction is seen both in males and females which is not commonly known to most people. Type II diabetes is a complex disorder. Many factors responsible are: genetic tendancy, pancreatic function, sesitivity of muscles to insulin, fat stores in the liver as well as grade of activity and lifestyle. Even though, some patients with morbid obesity do not have diabetes, their pancreas secretes higher level of insulin due to the insulin resistance. Insulin resistance varies from person to person. Hence everyone with morbid obesity does not necessarily get diabetes but may have pre diabetes or weight related co-morbidities and fatty liver disease. At the same time some people woth lesser grade of obesity maty have diabetes. thorough investigations to know the type of diabetes, pancreatic function are necessary since there are many genetic variants of diabetes which appear like type 2 diabetes but they are not.

लठ्ठपणा म्हणजे ज्या व्यक्तीच्या शरीरात चरबीचे प्रमाण अधिक असते. त्या अनुषंगाने येणाऱ्या व्याधी असू शकतील. त्यामुळे दिसायला फार जाड नसलेला माणूस लठ्ठ असू शकतो व त्याला उपचाराची गरज असते. या उलट अतिवजन असलेल्या माणसात चरबीचे प्रमाण अधिक असतेच असे नाही. परंतु स्नायू, हाडे ही मोठी असू शकतात. काही व्यायामपटू, वेटलिफ्टर्स आदींना आजार नसून उपचाराची गरज भासत नाही. अर्थात अतिवजन असलेला माणूसही लठ्ठच समजला जातो. त्यालाही उपचाराची गरज असू शकते.

लठ्ठपणाचा आजार हा अनुवंशिक असतो. त्याबरोबर अधिक उष्मांकाचा आहार, व्यायामाचा अभाव, बैठे काम, मानसिक तणावामुळे लठ्ठपणा येतो. परंतु, मधुमेहाची पूर्वीचा इतिहास असेल थायरॉईड, हार्मोनची कमतरता, स्त्रीबीज ग्रंथीचा आजार व त्यामुळे होणारे हार्मोनचे असंतुलन. उदा. स्टेऱॉईड्ससारखी मधुमेहावरील काही प्रकारची औषधे मानसिक आजारावरील अथवा अपस्मारावरील औषधे देखील लठ्ठपणा होण्यास कारणीभूत होतात. यापैकी एक किंवा अनेक कारणे असू शकतात. काही वेळा वजन वाढल्याचे काऱण शोधणे देखील अवघड असते. मानवाच्या उत्क्रांतीअवस्थेत, दुष्काळी अवस्थेला तोंड देण्यासाठी शरिरात साठवेलली चरबी ही उर्जेसाठी वापरता येण्याची शक्यता अधिक असते. असे असताना जास्त उर्जेचे सेवन झाल्यास पचनसंस्था (metabolism) बिघडून लठ्ठपणा हा आजार होतो. त्याबरोबर लठ्ठपणामुळे होणाऱ्या व्याधींचा तो रुग्ण शिकार होतो.

लठ्ठपणा झाल्यास माणसाच्या संपूर्ण शरिरावर दुष्परिणाम होऊ शकतो. अतिघोरणे, हृदयविकार, दम लागणे, उच्चरक्तदाब, डायबेटिस टाईप 2, सांधेदुखी, पाठीच्या मणक्याचे आजार, पायांच्या शिरांचे विकार, पायावर सूज, तसेच वंध्यत्व, नपुसंकत्व आणि इतकेच नव्हे तर काही प्रकारचे कर्करोगदेखील अतिलठ्ठपणामुळे होऊ शकतात.

वाढता लठ्ठपणा ही त्या व्यक्तीसाठी आरोग्याचा मोठा धोका ठरू शकतो. पण त्या व्यक्तीच्या कुटुंबातील खर्चाचा बोजा फार वाढतो. व्यक्तीच्या उत्पन्न मिळविण्याच्या क्षमतेवर वाईट परिणाम होतो. कारण लठ्ठ व्यक्तीची मानसिक, व सामाजिकदृष्टया पंगू असते. लठ्ठपणा त्याच्या सोबतच्या आजारांवरील उपचारांच्या खर्चामुळे आर्थिक ताण वाढतो. परिणामी, राष्ट्राच्या अर्थकारणावर मोठा बोजा ठरतो.

लठ्ठपणावरील उपचारांचा विचार करताना दोन प्रकारात विचार करावा लागेल. आंतरराष्ट्रीय संकेतानुसार व्यक्तीचा बॉडी मास इंडेक्स (बीएमआय) हा मोजणे आवश्यक असते.

बीएमआय ........ व्यक्तीचे वजन (किलोग्रॅममध्ये) (kg/m2)व्यक्तीची उंची (मीटरमध्ये) या प्रश्नाचे उत्तर जर 30 किंवा 32 पेक्षा अधिक असेल तसेच मधुमेहासारखा आजारही असेल तर आपण आहारनियंत्रण, व्यायाम या वजन कमी करण्याच्या उपायांचा शास्त्रीयदृष्ट्या विचार करणे अयोग्य असते. जर व्यक्तीचा बीएमआय 32पेक्षा कमी असेल व तसेच कोणताही आजार नसेल तर व्यक्तीला योग्य पोषक कमी उष्माकांचा आहार आणि योग्य व्यायामासह तज्ज्ञांच्या सल्ल्याने थोडी वैद्यकीय शास्त्राने मान्य केलेली औषधे अशा घटकांचा एकत्रित उपाय केल्यास वजन कमी करू शकतो. परंतु, अशा पद्धतीने कमी केलेले वजन टिकविणे हे व्यक्तींमध्ये अंत्यत अवघड असते.

जर बीएमआय 30 किंवा 32पेक्षा अधिक असेल आणि जोडीला वरील यादीतील मधुमेहासारखे आजार असतील तर शास्त्राच्या मते अशा व्यक्ती केवळ बॅरिअट्रीक किंवा ओबेसिटी शस्त्रक्रियेचा उपाय सांगू शकतो. ज्यामध्ये व्यक्तीच्या पचनसंस्थेत योग्य ते बदल लॅप्रोस्कोपीच्या सहाय्याने केले जातात. जेणेकरून व्यक्तीतील चरबीचे रुपांतर उर्जेत होते. केवळ छिद्रामधून चिरफाड न करता केलेली शस्त्रक्रिया असते. व्यक्तीचे वजन आपोआप कमी होते. त्या काळात भूकेचे नियंत्रण होते. शस्त्रक्रियेमुळे लठ्ठपणा संबंधित मुधमेह (टाईप 2) हा आजार आपोआप व फारच आश्चर्यकारकरित्या वेगाने बरे होतात. लठ्ठ व्यक्तीला नवजीवन मिळते.

- लठ्ठ मूल ते पूर्ण कुटुंबाच्या चुकीच्या सवयींचा परिणाम असण्याची दाट शक्यता असते. मूल जाड होत असेल तर प्रथमतः त्याची वैद्यकीय तपासणी तज्ज्ञ डॉक्टरांकडून करवून त्याच्या वजनवाढीचे काही वैद्यकीय कारणे (जसे prader wili syndrome) आहेत का हे तपासले पाहिजे. जर काही उपचारातून योग्य कारण सापडले तर त्यावर उपचार केले पाहिजेत. मुलांचे आई -वडिल, भाऊ, बहिण व इतर कुटुंबाची मदत घएऊन त्या मुलाच्या खेळायच्या सवयाची माहिती करून घेतली पाहिजे. संतुलित पण मुलाला आवडले अशा आहाराचे नियोजन कुशल अशा आहारतज्ज्ञांकडून केले पाहिजे. या सर्व उपाययोजनेत त्या मुलाच्या शालेय, शिक्षकांचा व मित्र परिवाराचा सहभाग अत्यावश्यक आहे.

व्यक्तीचा बीएमआय 32 kg/m2 पेक्षाअधिकअसेलअथवा 30kg/m2 पेक्षा अधिक असेल आणि मधुमेह, रक्तदाब, अधिक प्रमाणात कोलेस्टरॉल, सांधेदुखी अशा प्रकारचा एखादा आजार जरी असला तरी त्याला बॅरिअट्रीक शस्त्रक्रिया (ओबेसिटी) पर्याय शास्त्रीयदृष्ट्या योग्य ठरू शकतो. त्यापेक्षा कमी बीएमआय असेल आणि जीवनशैलीत योग्य बदल केल्यास लठ्ठपणावर नियंत्रण मिळविणे शक्य होते. परंतु, आशिया खंडातील नागरिकांमध्ये 30 पेक्षा अधिक बीएमआय असेल तर त्यांच्यात लठ्ठपणाची लक्षणे दिसून येतात. कारण जीवनशैली बदलल्याने त्यांच्यात लठ्ठपणा येत नाही तर शरिरातच चरबी तयार करण्याच्या यंत्रणेत बिघाड निर्माण झाल्याने चरबी वाढते. त्यावर शस्त्रक्रियेशिवाय पर्याय राहत नाही. शस्त्रक्रियेनंतर कमी केलेले वजन सामान्य व्यक्तीप्रमाणे टिकवून ठेवणे शक्य असते.

लठ्ठपणावरील औषधे फार कमी आहेत. वैद्यकशास्त्राची संमती तसेच आंतरराष्ट्रीय कायद्यानुसार आहेत अशी औषधे उपलब्ध आहे. त्यांच्या दुष्परिणामांबद्दल अथवा जास्त काळ घेतल्यास होणाऱ्या दुष्परिणामांचा अजून सखोल अभ्यास होणे गरजेचे आहे. त्यामुळेही औषधे तज्ज्ञांच्या सल्ल्यानुसार घेणे उपयुक्त ठरते. ही औषधे सामान्यांसाठी महागडी ठरतात.

याच कारणासाठी लठ्ठपणाच्या उपायांसाठी कोणत्याहीजाहिरातील बळी पडू नये. फक्त शास्त्रोक्त उपायच करावेत.

वीस टक्के पेक्षा वजन अधिक असेल तर तो लठ्ठपणा मानला जातो. शरिरात चरबीचे प्रमाण मुख्यतः पोटाच्या भागात अधिक असेल तर त्या व्यक्तीला लठ्ठ म्हणता येईल. बॉडी मास इंडेक्सनुसार 23 ते 27 बीएमआय (वजन जास्त), 27 ते 32 (लठ्ठपणा) आणि 32 ते 37 (अतिलठ्ठपणा) व त्यापेक्षा अधिक अशी लठ्ठपणाची वर्गवारी करता येते.

लठ्ठपणा कमी करण्यासाठी प्रतिबंधात्मक उपाययोजना महत्वाची असते. परंतु, उपचारांमध्ये आहार नियंत्रण, पोषक आहार व दैनंदिन व्यवहारात शारिरीक हालचालींना प्राधान्य देणे हे महत्त्वाचे असते. सर्वाधिक उष्मांक असलेले जंक फूड, तळलेले, गोड पदार्थ खाण्याचे टाळणे आवश्यक आहेत. रोज शक्य तेवढे चालणे, वाहनांचा कमी वापर, जिन्याचा वापर, नोकरांवर कमी अवलंबून राहणे, अशा पद्धतीने बदल केले पाहिजेत. व्यायाम हा प्रतिबंधात्मक व कमी केलेले वजन राखण्यासाठी तसेच वजन कमी करताना शारिरीक क्षमता व आकार राखण्यासाठी महत्त्वाचा असतो.

बीएमआय ........ व्यक्तीचे वजन (किलोग्रॅममध्ये) व्यक्तीची उंची (मीटर स्क्वेअर वर्ग m2) हे वजन आणि उंचीचे विशिष्ट सूत्र आहे. जागतिक आरोग्य संघटनेप्रमाणे (who) बीएमआय 18 ते 22.9 म्हणजे योग्य समजला जातो.

लठ्ठ मूल हे इतर सहकाऱ्याच्या व समाजाच्या अवहेलनेचा विषय होऊ शकतो. त्याच्या शारिरीक तसेच बौद्धीक क्षमतेवर फार वाईट परिणाण होतो. खेळणे, बागडण्याच्या त्याच्या अक्षमतेमुळे ते इतरांपासून बाहेर फेकले जाते. या सर्वांचा परिणाम लठ्ठ मुलाच्या बौद्धीक, मानसिक विकासावर होतो. अशा मुलांमधील लठ्ठपणाच्या वाढत्या प्रमाणामुळे शेवटी राष्ट्राच्या विकासावर परिणाम होतो. कारण लठ्ठ मूल हे मोठे होऊन आरोग्यपूर्ण व्यक्ती बनूच शकत नाही.

हो. परिणाम होतो. लठ्ठपणामुळे उदासिनता. सामाजिक क्षेत्रात सर्वत्र हीनवण्याची भावना तसेच अवहेलनाच्या परिणामास तोंड द्यावे लागते. दैनंदिन व्यवहारात चालणे, उठणे, जीना चढणे, बूट घालणे, चप्पल घालणे, वाकून काम करणे तसेच शारिरीक संबंधानांही लठ्ठपणामुळे फार मोठी बाधा येते.

लठ्ठपणामुळे शरिरातील सर्व भागांवर ताण पडतो. त्यामुळे मधुमेह टाईप 2 हा आजार आशिया खंडात सर्वाधिक दिसून येतो. पायापासून डोक्यापर्यंत त्याचे परिणाम दिसून येतात. पायांना सूज येणे, शिरा फुगणे, तुटणे, पायाच्या पोटऱ्या दुखणे, गुडघेदुखी, गुडघे झिजणे, घोट्याचे आवरण झिजणे. त्याशिवाय...

- जननसंस्थेचे विकारही बळावतात. नपुसंकत्व, स्त्रीबीज तयार न होणे, वंध्यत्व होण्याचा धोका असतो.

- मूत्रविसर्जनावरील नियंत्रण सुटते. अथवा खोकल्यावर, हसल्यानंतर लघवी थेंब बाहेर पडणे, पोटाचा घेर वाढल्याने...

- लिव्हरमध्ये पित्ताशयाचे खडे तयार होणे. खूप मोठ्या श्रमाने धाप लागणे, दम लागणे, सतत निरुत्साह, थकवा जाणवणे.

- घोरण्याचा आजार बळावणे,

- हृदयविकाराचा धोका लहान वयात वाढणे,. अतिरक्तदाब वाढणे तसेच काही प्रकारच्या कर्करोग वाढण्याची शक्यता अधिक असते

लठ्ठपणामुळे महिलांना वंध्यत्वाचा धोका होतो. स्त्रीचे वजन वाढल्यास तिच्या स्त्रीबीज निर्मितीवर परिणाम होतो. त्याची निर्मिती बंद होऊ शकते. दिवस राहिले तरी गर्भ टिकणे लठ्ठपणात अवघड असते. गर्भाची वाढ कमी होऊ शकते व प्रसूती नैसर्गिकरित्या होण्यास अडचण येऊ शकते.

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