Obesity is a serious, chronic disease that can have a negative effect on many systems in your body. People who are overweight or obese have a much greater risk of developing serious conditions, including:

Heart disease
Type 2 diabetes
Bone and joint disease
The prevalence of childhood obesity has increased dramatically over the past few decades, and obesity during adolescence is associated with significant medical morbidity during adulthood. Eating disorders and obesity are usually seen as very different problems but actually share many similarities. Eating disorders (EDs) are the third most common chronic condition in adolescents, after obesity and asthma.

In fact, eating disorders, obesity, and other weight-related disorders may overlap as girls move from one problem, such as unhealthy dieting, to another, such as obesity. Understand the links between eating disorders and obesity and promote healthy attitudes and behaviors related to weight and eating.

What is an Eating Disorder?

Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape. Eating disturbances may include inadequate or excessive food intake which can ultimately damage an individual s well-being. The most common forms of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder and affect both females and males.

Signs & Symptoms of an Eating Disorder:

A man or woman suffering from an eating disorder may reveal several signs and symptoms, some which are:

Chronic dieting despite being hazardously underweight
Constant weight fluctuations
Obsession with calories and fat contents of food
Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, and/or hiding food
Continued fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
Depression or lethargic stage
Avoidance of social functions, family and friends. May become isolated and withdrawn
Switching between periods of overeating and fasting
What are the health risks associated with these disorders?

Stunted growth.
Delayed menstruation.
Damage to vital organs such as the heart and brain.
Nutritional deficiencies, including starvation.
Cardiac arrest.
Emotional problems such as depression and anxiety.
What is Obesity?

Obesity means being overweight by the accumulation of excess fat within the body. Obesity is defined to some extent by measuring Body Mass Index (BMI). People become obese by consumption of excess calories, imbalance between calories intake and calories outgoing, leading a sedentary life, lack of sleep , disturbances in lipid metabolism and intake of medications that put on obese.

What are the risks associated with obesity?

Obesity increases the risk for:

High blood pressure
Stroke
Cardiovascular disease
Gallbladder disease
Diabetes
Respiratory problems
Arthritis
Cancer
Emotional problems such as depression and anxiety
How eating disorder and obesity are related?

Eating disorders and obesity are part of a range of weight-related problems.

Body dissatisfaction and unhealthy dieting practices are linked to the development of eating disorders, obesity, and other problems.
Binge eating is common among people with eating disorders and people who are obese.
Depression, anxiety, and other mood disorders are associated with both eating disorders and obesity.
The environment may contribute to both eating disorders and obesity.
Help adolescents develop healthy eating habits:

Help children learn to control their own eating.
Offer children a variety of healthy foods at meal and snack times.
Eat dinner together as a family most days of the week.
Be aware of your child's emotional health or else consult a psychologist
Encourage children to participate in sports, dance, swimming and other physical activities.
Counteract harmful media messages about body image. 
The splendid approach:

The approach should be quite simple. A proper diet plan, nutritious foods and fruits with proper exercise can do a world of good to you. 

Obesity Due To Eating Disorders!

Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

Bariatric surgery is advised in cases of morbid obesity (BMI >37.5). This degree of obesity is usually associated with comorbidities like diabetes, hypertension, dyslipidemia, obstructive sleep apnea, infertility, knee joint pains, etc. In the present scenario, when all efforts of weight loss seem ineffective, bariatric surgery seems to be the only way to lose excess weight in the morbidly obese patients. Undergoing bariatric or weight loss surgery requires some preparation prior to surgery, and also after surgery to ensure its success.

Most of them will have an enlarged fatty liver, hence a low-calorie diet is advised so that the fatty liver does not pose problems during surgery. Due to obesity, there will be a compromise on the lung function, decreasing the lung capacity. Hence improving the lung function is of importance from the anaesthetic point of view and also concerning the quick postoperative recovery.

For the first few months following surgery, there will be a significant reduction in the intake of food, as the size of the gastric pouch has been decreased. In addition, there will be some restrictions on the caloric density of food for the first few months after surgery. However, for a person who understands these requirements and is willing to so, the long-term benefits are multiple. 

Read on to know how bariatric surgery can turn your life around.

Weight loss: One of the first benefits they would see is weight loss which starts right from the first week following surgery. The patients are so very happy to see this weight loss which they had not seen in spite of all their attempts at losing weight over the last few years. This boosts their morale and helps them to follow the instructions given to them more diligently, as they are seeing results. The weight loss is maximum in the first 6 months following surgery and in fact, this is called the honeymoon period for weight loss. A monthly follow up with the doctor is essential and up to 60 to 70% of the excess weight is lost in the first 6 months. It takes another 3 to 4 months to lose the remaining excess weight.

Emotional gains: For a person who is used to seeing an obese image in the mirror, it is a great morale booster to see that image changing to a slender version. This is a big boost to continue the effort towards diet and exercise, which will only improve the confidence and esteem levels.

Overall health: Morbid obesity is not an isolated condition. It brings with it a host of medical issues including sleep apnoea, diabetes, hypercholesterolemia, etc. With obesity under control, these conditions also begin to improve and the person s overall quality of life begins to improve. This, in turn, provides a big boost for the person to continue working at weight loss.

Reduced healthcare expenses: Obese people often need to eat various medications to manage overall health. There could also be emotional health management issues. With this controlled, the patient spends less on overall health and feels good again.

Social connect: Morbid obesity is both a physical and an emotional blockage for a person to engage socially. Once it is controlled, the person is more confident in meeting people and participating in social activities. This further leads to increased overall happiness.

Active life: With reduced weight, the person s level of activity improves. What seemed difficult earlier is suddenly doable. A person who could not walk some steps is able to, and this is a big booster.

People who undergo bariatric surgery require quite a bit of effort to change their overall lifestyle. However, the benefits are for them to see for themselves, and that is the biggest motivator to continue working towards their goal. Family support is definitely required to boost up the morale. The benefits are there for all to reap.

Bariatric Surgery - Stunning Gains You Must Know!

Being overweight is becoming a common sight. However, opting for bariatric surgery is not the first option for everyone who is obese. Also to remember is that morbid obesity is not an isolated condition. It affects a person s overall physical and mental health in various ways, and therefore bariatric surgery becomes an option only as a last resort. 

Some defining criteria for this surgery would be:

A male who is at least 100 pounds overweight for his height or a female who is at least 80 pounds overweight for her height. This puts them at a body mass index (BMI) of more than 40.
If the BMI is in the range of 35 to 39 and if there are significant health issues like metabolic syndrome, then bariatric surgery can be done. For BMI less than 35, other conservative measures are usually tried before resorting to a surgical approach.
Most people with BMI in the range of 35 and above will have health issues like sleep apnoea, heart disease, lipid disorders, and metabolic syndrome.
Conservative measures to lose weight including diet changes and exercise have failed to produce any desired results.
The person, in addition to physical health, should also be emotionally strong to undergo the demands of bariatric surgery. There are changes involving almost all body systems including digestive, respiratory, cardiac, and musculoskeletal, and so the person needs to be prepared for a lifestyle change.
Strict lifestyle changes including diet and exercise are required, so the person needs to be counseled and convinced about these. A person who can see the long-term benefits will be willing to take the effort.
It is also essential that the person has a strong social support system. For immediate post-op care when skin flaps need to be managed, and for long-term emotional support to manage emotional issues, it works wonders if there is a strong social network. The results are usually better in such people.
A person s overall health would be screened to make sure the lab tests are well within acceptable limits before surgery. It would be unreasonable to get these numbers within limits, if they are way too beyond acceptable limits.
Not the least consideration, but bariatric surgery is an expensive affair. It requires not just surgical costs, but also post-op costs. The good thing, however, is that overall healthcare costs would come down, once the results are visible.
Identifying the right candidate for a bariatric surgery is very essential, as doing this extensive surgical approach on an unsuitable candidate would be a failure.

Bariatric Surgery - Who Is Eligible For The Same?

Obesity can make life miserable. From unhealthy eating habits to unhealthy lifestyles and medical conditions, obesity can be an amalgamation of many factors. Obese people are a greater risk of suffering from many serious health complications like type-2 diabetes, mood swings, and depression, cardiac problems, high blood pressure and high cholesterol, to name a few. It does not stop there. More alarming is the fact that obese people are an increased risk of suffering from different types of cancer.

Bariatric surgery comes as a saviour for highly obese people (with a BMI over 40), who have tried every possible treatment under the sun to lose weight without any success. Bariatric surgery has helped many severely obese people attain a healthy weight. Bariatric surgery can be of three types;

Gastric bypass surgery (Roux-en-Y): This is one of the most common types of weight-loss surgery practised worldwide. The procedure involves rearranging (dividing) the stomach into a smaller upper pouch and a larger lower part. The smaller pouch is then connected to the small intestine. The food consumed will pass into the small intestine through the pouch. The idea is to rearrange the stomach in such a way that a person consumes a lesser quantity of food.
Gastric banding (Laparoscopic Adjustable Gastric Band): In this procedure, the surgeon creates a small pouch at the upper part of the stomach by placing a band (lap band or A-band) around it. The pouch, true to its name, is used to hold the food consumed. The purpose of placing a band around the stomach (upper part) is to reduce the intake of food.
Sleeve Gastrectomy (Gastric Sleeve surgery): In Sleeve Gastrectomy, surgeons remove a large portion of the stomach, leaving behind only a small sleeve-like pouch (hence the name). Like the other two surgeries, sleeve gastrectomy also aids in limiting the consumption of food.
Duodenal switch: The fourth type of bariatric surgery, Duodenal switch with biliopancreatic diversion, is not very commonly used. Bariatric surgery has several health benefits. In addition to the weight loss, it plays a pivotal role in lowering the incidences of Type-2 Diabetes, depression, anxiety, coronary artery problems, sleep apnea cardiovascular diseases.
Research also suggest that bariatric surgery has been instrumental in reducing the chances of cancer (especially colon and breast cancer) by as much as 60%. The correlation between weight loss and reduced cancer instances is still a debatable topic. Some researchers and oncologists believe that the weight loss (bariatric surgery) brings about a hormonal modification which prevents the growth of tumour cells. Another study links obesity with an increased inflammation. In many cases, inflammation acts as a catalyst, accelerating the growth of cancer cells. Research is still going on to understand this correlation (obesity and reduced cancer rates) better.

Bariatric surgery has its share of risks and demerits. Consult your physician and get yourself thoroughly examined before opting for the surgery.

Does Bariatric Surgery Reduces The Risk Of Cancer?

If you have taken the big decision to go ahead with bariatric surgery, one thing you need to prepare for well in advance is the additional effort that is required after the surgery to ensure it is a success. The results will be evident only after a few months post the surgery. This period requires your constant attention. 

Listed below are some after-care measures that are essential for the success of a bariatric surgery.

Hospital stay: Most patients are advised hospital stay for four days, during which the hospital staff will ensure the sleeve is working fine. No food is allowed for 48 hours. Diet is gradually advanced from water to clear liquids, about 50 ml to 100 ml and then to 150 ml.
Wound care: Depending on whether a laparoscopic or open surgery was done, the number and location of incisions will vary. However, the wound should be maintained clean and it should be ensured that there is no infection of the site. Wound care should be done by the nursing staff if required. Suture removal, if required, should be done as per doctor s advice.
Pain management: Finish the course of antibiotics and pain killers to ensure infection is completely gone. Pain would continue, if the infection is not completely controlled.
Diet: The first two weeks would be a completely liquid diet. The next two weeks will consist of a pureed diet. After these four weeks, solid foods will be introduced.
Foods to avoid after a bariatric surgery include anything with a higher protein content and anything that has too much oil as the stomach s ability to digest these is reduced. Refrain from:

Carbonated beverages
Hard meat
Nuts and seeds
Fried foods
Food items to include post bariatric surgery include those which are easy on the stomach, including:

Liquids such as soups, broth, juice, and milk
Pureed cooked vegetables and eggs
Soft mashed food including meat and vegetables
Adherence to this will reduce complications. While eating, the patient should also remember to chew nicely, eat and drink slowly, increase water intake throughout the day, and avoid fats and sugar. It is advisable to eat three proper meals a day and avoid snacking during the day.

Remember that the need for bariatric surgery arose in the first place due to uncontrolled eating of oily food. After undergoing a bariatric surgery, diet pattern is definitely going to move to a healthier side with reduced fat and sugars. It is not an easy shift, but definitely required, if the surgery is to be a success. Imagine the new you and you will be able to do it!

Bariatric Surgery - Aftercare Tips You Must Follow!

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