Bariatric Surgery (Obesity Surgery)
Morbid obesity is a lifestyle disease which is chronic and affects the patient for life. Patient puts on excess fat which in males is around the trunk and in females around the buttocks and thighs. To calculate the extent of the disease a simple formula is used. We define the body fat in the following way.
Body Mass Index (BMI) = Weight in kg / [(Height in meter) X 2 ]
Pattern of BMI
|Type of Body||BMI Range|
|Average build||18 - 22.9 |
|Overweight||23 - 27.4|
|Obese||27.5 - 34.9|
|Morbidly obese||35 - 39.9|
|Morbidly morbid obesity||> 40|
|Super Obese||> 60|
In the west it is a poor man's disease while in India it's a disease of rich and elite. Enough evidence exists to prove that surgery is the most permanent answer to morbid obesity.
Surgeries are tailor made according to the eating habits and BMI of the patients. They are either restrictive procedure or malabsorptive procedure. Restrictive Surgery in form of Adjustable Gastric Banding (AGB), Sleeve gastrectomy or malabsorptive procedure like Roux en Y gastric bypass (RYGBP) or Biliopancreatic diversion (BPD) are done. Surgery for morbidly obese patient where in other method of treatment have failed has evolved for long time but with the advent of being done Laparoscopically has added a new thrust in this field.
Those with the habit of eating too much sweets are not good candidates for gastric banding. Psychological analysis of all patients is done to determine any eating disorder in them. Patient determination, body image and existing depression if any are managed by the psychologist. Sometimes a two stage procedure is offered in super obese patients to reduce the risk and complications..
Complete medical examination and investigations are done prior to the surgery to evaluate the fitness of the candidate for anaesthesia and to asses any co-morbid conditions if present. The patients have to be committed to undergo a change in their lifestyle and adopt to the new dietary and fitness regime prescribed.
Morbidly obese patients can suffer from
· Heart diseases
· Cancer of breast, prostate or colon
· Knee or back pain (Osteoarthritis)
· Public ridicule due to their size and hence Depression
· Discrimination at work
Modern laparoscopic treatment offers the following advantages
· Short stay
· Practically pain free
· No wound related complications
· Patients returns to work in less than a week
· Cosmetically 5 tiny scars ½ - 1 ½ cm
· Low complication rate comparable to any other surgery
· Follow up is needed every 3/4 months
· Improves overall quality of life (QOL)
Gastric banding is the simplest and safest option available with very low mortality and morbidly. At the end of one year most patients loose 30 to 40 % of excess weight (E.W.L.) and in majority of the patient 80 to 90 % of the co-morbidity conditions get resolved.
Sleeve Gastrectomy is another procedure is what we can offer for patients higher BMI which will help them to loose weight more rapidly without any serious malabsorption. It has no intestinal element and lower rate of complication.
Gastric Bypass is offered to patients with very high BMI and 'sweet eaters' Its helps the patients to loose weight very rapidly and at the end of one year patients loose about 40-50 kgs. A portion of the small bowel is bypassed thus delaying food from mixing with digestive juices to avoid complete absorption.
In most cases the patients report an early sense of fullness, combined with a sense of satiation, that reduces the desire to eat.
There are just a few surgeons who perform these procedures regularly and we are now offering these procedures at Agrawal Clinic and Asian Heart Institute, Mumbai.
For further details write to firstname.lastname@example.org to get an appointment at Mumbai
Dr Abhay Agrawal
MS; PGD Lap Surgery (France)
Laparoscopic Obesity Surgeon
LATEST: After weight loss surgery, people have nearly twice the expected risk of breaking a bone and an even higher risk of a foot or hand fracture,
a new study has found. The results were presented at The Endocrine Society's 91st Annual Meeting in Washington, D.C. Full Report
Asian Heart Institute
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