Frequently asked question
1. How do you classify obesity and where am I?
Obesity is defined as a body mass index (BMI; weight in kg/[height in meters]2) ≥30 kg/m2, in an overall classification in which the healthy range of weight is 18.5 to 24.9 kg/m2, overweight is 25 to 29.9 kg/m2, class 1 obesity is 30 to 34.9 kg/m2, class 2 obesity is 35 to 39.9 kg/m2, class 3 obesity is ≥40 kg/m2, class 4 obesity (superobesity) is 50 to 59.9 kg/m2 and class 5 obesity (super-superobesity) as >60 kg/m2
2. What are the main complications of obesity?
Obesity is closely related to a whole gamete of complications ranging from high cholesterol, type 2 diabetes, high blood pressure, heart disease, stroke, cancer, including cancer of the uterus, cervix, ovaries, breast, colon, rectum and prostate, sleep disorders, depression, gallbladder disease, gynecologic problems, such as infertility and irregular periods, nonalcoholic fatty liver disease, osteoarthritis and skin problems, such as poor wound healin
3. What are the main risk factors related to obesity?
The main risk factors are genetic- your genes may affect the amount of body fat you store and where that fat is distributed, inactivity, unhealthy diet and eating habits, family lifestyle, quitting smoking- quitting smoking is often associated with weight gain but in the long run, however, quitting smoking is still a greater benefit to your health than continuing to smoke, pregnancy – during pregnancy a woman’s weight necessarily increases and some women find this weight difficult to lose after the baby is born, lack of sleep, certain medications and aging- as you age, hormonal changes and a less active lifestyle increase your risk of obesity.
4. How can we effectively combat obesity?
Well planned, well assisted and sustained effort is required to loose weight and maintain it. It is achieved with low calorie and very low calorie diets, engaging in regular and supervised exercise programs and life style modifications brought through counseling. But in higher class of obesity these programs are incorporated with different weight reducing (bariatic) procedures to achieve sustained and significant loss of excess body weight.
5. What is bariatic surgery?
These are laproscopic procedures done to assist sustained and significant loss of excess body weight. This approach has the advantages of fewer wound complications, less postoperative pain, a briefer hospital stay, and more rapid postoperative recovery. Bariatic surgery can be restrictive (where the stomach capacity is reduced and hence the food intake) or malabsorptive (where absorption of macronutrients are restricted)
6. How much weight can be reduced through these approaches?
It depends on the type of bariatric surgery one undergoes. Generally 60 to 80 % of the excess body weight is lost in two years time.
7. What are the other advantages of such weight loss?
The purpose of bariatric surgery is to induce substantial, clinically important weight loss that is sufficient to reduce obesity-related medical complications to acceptable levels. The loss of fat mass is associated with improved insulin sensitivity and glucose disposal and offer cure in diabetes (85%), hypercholesterolemia (85%) and hypertension (66%). Loss of fat also reduces intra-abdominal pressure, this change may result in improvements in urinary incontinence, belching and abdominal distension. Risk of venous thrombosis and sleep disorders are also improved greatly. Mechanical improvements include less weight bearing on joints, enhanced exercise capacity, and decreased fatty tissue around the neck, which relieves obstruction to breathing while asleep. In general bariatric surgery improves quality of life and increases the life span.
8. Is it a major surgical procedure and how long do I have to be in hospital?
It is a laparoscopic procedure done under general anesthesia. Patient is mobilized as early as 6 hrs after surgery and usually spends about three days in the hospital.
9. Can I eat at my wish after surgery?
The procedure we usually do in patients weighing up to about 140 kgs (BMI: 40-50 kg/m2) is sleeve gastrectomy. A structured diet plan and repeated sessions of psycho-social counseling are a part and parcel of the entire program. Patients who stick to that plan definitely loose more weight. Patients who consume high calorie liquids and semisolids usually find it difficult to loose weight.
10. When can I conceive after surgery?
Pregnancy should be discouraged during periods of rapid weight loss (12 to 18 months postoperatively)