Obesity - Symptom, Treatment And Causes

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.

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

6. 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 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:- 

1. 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.

2. 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.

3. 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.

4. 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.     

5. 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.

6. 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.

7. 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.

8. 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.

Are you gaining excessive amount of weight during your pregnancy, well you are not alone.  Most of the pregnant women tend to be overweight or obese. You are viewed as overweight, if your pre-pregnancy body mass index (BMI) is approximately between twenty-five and twenty-nine. Your BMI is the relationship between your height and weight. You are considered obese, if your BMI is thirty or more.

However, here are some ways with which you can control the weight gain during pregnancy:

1. Eat a solid, yet less-calorie diet: Utilize a convenient pregnancy food journal to ensure you are getting enough supplements and drinking a lot of water every day. The journal is additionally helpful for keeping track of your mood swings and appetite levels, so you can spot patterns you may need to change. Since you realize that you have to take after a particular eating regimen, the following are very solid for you:
   • Crisp leafy foods
   • Oats and bread made with whole grains
   • Low-fat milk and dairy items
   • Foods rich in folate such as strawberries, spinach and beans
   • Unsaturated "good" fats such as olive oil, canola oil, and shelled nut oil
2. Regular exercise: In case you are a relative newcomer to work out, you can start with pregnancy exercise for beginners. You can practice low-impact exercises; for example, walking, swimming and light heart stimulating exercises. Never begin an exercise without first talking with your medicinal services supplier or doctor. Furthermore, make sure to you adhere to the thirteen principles of safe pregnancy work out. A few women do get in shape during pregnancy in case that they roll out solid eating regimen and make way for life improvements, so make sure to check in with your specialist if this happens.
3. Comprehend your calorie needs: As specified before, not all pregnant women have to put on equivalent measures of weight. Thus, you have to know precisely what number of calories you require. Talk with your specialist to get the correct number.
4. Eat frequent, small meals: This is true when you need to deal with your weight, pregnant or not. Eating successive little dinners is particularly helpful when you are pregnant. Eating a full feast makes you wiped out.
5. Taking prenatal pre-natal vitamins: This is something your specialist will recommend in any case. Yet, in case that you require an extra motivation to take your pre-birth vitamins consistent, then this is it. As you most likely are aware, your body needs additional food and nutrients during pregnancy. In case that you need to deal with your weight and take in the supplements without stacking yourself with calories, take your vitamins.

In case you have a concern or query you can always consult an expert & get answers to your questions!

As on date obesity is a major problem in India. As per the World Health Organization statistics, India ranks third on the list of most obese nations after US and China. Further, a survey revealed that Delhi has over 35 percent of teens who are obese or overweight, which is an alarming number.

Obesity is a condition wherein you suffer from excessive body weight as a result of either genetic or lifestyle-related factor. This condition, if not taken seriously, can be life-threatening as obesity can put you at risk of developing chronic conditions like diabetes, cholesterol, blood pressure, and which in certain cases can lead to heart attack. Hence, it is crucial to undergo weight reduction.

Calculate the weight you need to lose
Before you begin to practice effective steps for weight loss, consider the amount of weight you need to shed. You should first measure your current weight and then calculate your body mass index (BMI) to find the amount of deviation from the recommended range. Then consider the difference between your current and ideal weight as your target.

Tips For Losing Weight

1. Eat Right

• Consult a nutritional expert- It all starts with the right diet. Your eating habits contribute significantly to your weight. If you are obese or overweight, then you should consult a health expert and have him prepare an appropriate diet based on your weight and body type.
• Balanced diet- Make sure you have lean meats, fruits and green leafy vegetables as part of your diet. Also, cut down on the amount of food you consume and your intake of sugar, salt and fats gradually. Water is also the best medicine since it is helpful in flushing out toxins from your body. Make it a point to drink around 2 liters of water on daily basis. It will help clean your system and also keep you feeling full and hydrated.
• Regular meal time- Another effective tip is to eat regularly. If you skip meals, then your body starts storing excess fat to act as a reserve. If you eat regular meals in small portions, you not only slow down the fat storing process but also reduce the quantity of food you consume.
• Healthy options- Moreover, switch immediately to the modern-day marvel that is green tea, as it is rich in antioxidants. Green tea is highly effective if you aim to lose weight. If you do not prefer green tea, then aloe vera juice is an even better alternative.

2. Exercise
As an obese person, you need to exercise regularly. If you find it difficult to do exercise, take baby steps and start with easy sitting and lying exercises. Go out into the fresh air such as a garden and perform these exercises early in the morning for just 10 minutes. As you build your stamina, increase the intensity gradually.

3. Manage stress
Shed some of that stress in your life as stress and weight are directly correlated. Lose out on stress, and you will also lose those extra pounds.

4. Don’t neglect sleep
Six to eight hours of sleep is essential for a healthy being. Insufficient sleep results in increased levels of cortisol. Cortisol is associated with weight gain.Hence, it becomes crucial to rest enough.

Make sure you seek advice from your doctor and implement the necessary lifestyle changes to accomplish weight reduction effectively. In case you have a concern or query you can always consult an expert & get answers to your questions!

The word obesity in itself isn't a very pleasant sound. Being one of the most common problems in the world, it is become an epidemic in recent years. The best way to deal with it is to control it and to understand the symptoms and causes of obesity, one must know what exactly obesity is. Although there are multiple definitions of obesity, in general, obesity indicates weight that is greater than what is considered healthy. Even though a certain amount of body fat is necessary for storing energy, heat insulation, and shock absorption, an excess amount of body fat leads to obesity.

Causes of Obesity
A person’s weight is determined by a balance between calorie intake and energy expenditure. The body stores the excess calories in the form of body fat. The hormone leptin is responsible for the mechanism of fat regulation. If a person is suffering from leptin deficiency, then he can suffer from obesity. Also, diseases such as hypothyroidism and polycystic ovary syndrome contribute severely to obesity. Furthermore, body weight is determined by several factors such as an individual’s genetics, diet, metabolism, environment, culture, and behavior.

Obesity and Associated Health Risks
Obesity is not merely a cosmetic consideration but is also very harmful to a person’s health. Life expectancy is significantly reduced for people with BMI over 40. Obesity leads to insulin resistance which is a pre-diabetes condition that often leads to Type 2 (adult-onset) diabetes.Another major health risk of obesity is high blood pressure. Most obese people suffer from hypertension and increase in blood pressure is found more commonly in women than in men as a result of weight gain. Other health risks of obesity are cholesterol, stroke, heart attack and various forms of cancer such as breast and colon cancer.

How is Obesity Diagnosed?
Your doctor will give you a series of tests to confirm if you are obese. He will analyze your medical history taking into account your weight history, eating and exercise habits, your family’s health history, heart rate, and examination of heart, lungs, and abdomen.

Obesity is generally measured by calculating the body mass index (BMI). Body mass index takes into consideration a person’s height and weight as the two determining factors to calculate an individual’s appropriate weight. Body mass index is calculated by dividing a person’s weight in kilograms (kg) by their height in meters (m) squared. BMI shows high correlation with body fat content in adults since it exhibits a ratio between weight and height.

A full-grown adult with a BMI ranging from 25-29.9 is considered overweight while an adult with BMI over 30 is considered obese. An individual with BMI ranging from 18.5-24.9 is of normal weight. Waist circumference is measured to know the amount of abdominal or visceral fat stored around your waist. Women with over 35 inches waist circumference and men with over 40 inches waist circumference are prone to high risks of contracting diabetes and heart ailments.

It is a good practice to measure your BMI and Waist circumference once in a year. If they are more than the normal, it is best to consider a physician to get diagnosed with obesity and plan the best treatment option.

In case you have a concern or query you can always consult an expert & get answers to your questions!