Obesity & Surgical Treatments – Everything You Need To Know

Obesity has become a huge cause of concern in India in recent times. Being obese is completely different from being overweight. While there is a lot of awareness and written content of weight management, little is known about obesity and its treatment. The stigma associated with obesity has also shell-cased patients suffering from it from seeking medical help or knowing more about it.

This Anti Obesity Day (26th Nov) we start our fight against obesity with the awareness campaign #Indiafightsobesity. The main focus of this campaign is to make people aware of the health setbacks obesity can lead to and to eradicate the social stigma and taboo related to obesity and its treatment.

According to Dr Mohit Bhandari, Founder and Director, Mohak Bariatrics and Robotics, Indore, obesity is a health hazard and requires immediate medical supervision and treatment.

Dr Bhandari is one of the first bariatric surgeons to perform a robot-assisted bariatric surgery and the first and the youngest to have performed a documented obesity surgery in Asia. He also features in the Limca Book of Records in 2015 for performing 25 bariatric procedures in an 11-hour span with the help of a team of 40 doctors.

Candidates for bariatric surgery had to have a BMI greater than 40 kg/m2 or greater than 35 kg/m2 with associated comorbidities such as type 2 diabetes mellitus, arterial hypertension or sleep apnea-hypopnea syndrome.

Dr. Ashish Bajaj, MBBS, MD in Clinical Pharmacology and Toxicology

The Stigma Associated with Obesity in India

Treating obesity has always been surrounded by taboo and stigma majorly because it is still treated as a cosmetic procedure that is done to look toned and beautiful.

While you would be tempted to link the weight loss procedures with the actual obesity treatment, it is not the same. Although your weight might be due to water retention, muscle mass, bone weight and fat accumulation, obesity is linked only with the amount of fat in your body.

”People are not open to the idea of treatment for obesity because they don’t understand it. Obesity is considered cosmetic”

Some of the most common challenges associated with obesity treatment are as follows-

• Lack of awareness.
• Inhibitions due to the social stigma associated with it.
• Trying to fight obesity with lifestyle alterations and diet management only.
• Not having the right approach and attitude towards the disease.
• Waiting to get treated till it starts complicating your health.
• Treatments for obesity are considered cosmetic and not medical and hence people refuse to invest in such procedures.
• Not understanding the difference between being overweight, obese and morbidly obese.

”In India, we have thousands of morbidly obese patients and we are only able to treat 1% of them”

How Has the Mindset of People Changed about Getting Treated for Obesity?

In the last five years, you can see a lot of change in the attitude of the patients with regards to obesity and its treatment. While our grandparents might have ignored their weight gain as overeating, we are more aware and concerned about our BMIs and are also aware of the various medical options available to treat obesity.

It is interesting to note that obesity might not just be due to an unhealthy lifestyle but can be associated with causes like genetic factors and hormonal imbalances which also need to be considered.

We now know that obesity within the BMI of 32 can be treated with lifestyle alterations and diet management and anything beyond that requires a different approach. Medical management and lifestyle modification cannot do much in the case of morbid obesity where surgery is the only option for sustained results.

Severe heart failure, unstable coronary artery disease, end-stage lung disease, active cancer treatment, and drug/alcohol dependency are some situations when bariatric surgery is not recommended.

Dr. Ashish Bajaj, MBBS, MD in Clinical Pharmacology and Toxicology

Treatments for Obesity

• For those who are slightly overweight or mildly obese, a slight diet management and lifestyle alteration would suffice.
• For some with a higher BMI, doctors might advise a medically managed weight loss which would involve minimum or no invasive weight loss procedures and behaviour in a clinical setting.
• You might also be put on medications that would help you in managing your BMI and weight. Pharmacotherapy coupled with a low-calorie diet and a healthy lifestyle has proven successful in treating obese patients.
• You would be morbidly obese if your BMI is over 40 or if you have any obesity-related diseases and you would be advised to undergo bariatric procedures.

Bariatric surgeries are proven to have long-lasting and a significant impact on weight loss and have been practiced by surgeons across the globe since around the 1960s. It can be divided into the Malabsorptive procedures (which involve the reduction of nutrient absorption), the Restrictive procedures (which decrease the food intake by adjusting the gastric band) and hybrid procedures which involve a bit of both.

”Surgeries which are done to manage obesity, are not cosmetic surgeries.”

Some of the health issues related to obesity are:

• Type 2 diabetes
• Hypertension
• Sleep Apnoea
• Arthritis and Gout
• Polycystic Ovarian Disease (PCOD)
• Stroke and Heart disease
• Cancer in the colon, breasts, esophagus, kidney, uterus lining, gallbladder and pancreas
• Gallbladder disease and gallstones

Endoscopic sleeve gastroplasty is a new weight loss procedure. It’s designed to reduce the volume of your stomach. It’s done by endoscope, which means there’s no cutting or scarring. Endoscopy has fewer side effects than surgery.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

Measuring Obesity

Measuring obesity varies as you age as your ideal weight and your overall body height change with age. While you can find more bone and muscle mass in young, it is less in adults.

Hence, you should take into account the body composition analysis, basal metabolic rate and bone and muscle mass to determine how obese you are. You must also take into account the obesity-related diseases and health complications you have in order to treat them effectively.

Here are some tips to manage your weight:

• Daily exercises,
• Minimum 45 minutes of high-intensity interval training.
• A healthy diet and lifestyle modifications.
• Regular weight checks and doctor consultations.

Conclusion

This Anti-Obesity Day, take a pledge to have an active lifestyle and manage your weight with the right attitude. While you do have a plethora of treatments available to treat obesity, only the right attitude and behavior towards it would ensure longevity and a healthy body.

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