|
| BMI | Interpretation |
|---|---|
| Below 18.5 | Under weight |
| 18.5-24.9 | Normal |
| 25-29.9 | Over weight |
| 30-34.9 | Obesity (Obesity I) |
| 35-39.9 | Severe Obesity (Obesity II) |
| 40 or more | Morbid Obesity (Obesity III) |
| 50 or more | Super Morbid Obesity |
Every great journey began as a decision once made, often a difficult one.Life is a sum of all our choices. However, when the choices are of a medical nature decision-making becomes a difficult business.
It is always the first step, though, that is the most difficult. Once the first step in the right direction is taken, the path ahead becomes easier. In the end what matters is the choice that you made. It does not matter how hard it was to make it. What matters is that you did. What is Obesity Surgery
Bariatric surgery is the collective term for a group of surgical procedures that are used for reduction of weight in obese persons. When other fat reduction methods such as diet management and physical exercise, are not effective, bariatric surgery is the best alternative to lose and manage weight in a planned manner.
In bariatric surgery, the size of the stomach is reduced. The portion of the stomach that produces Ghrelin (the hormone responsible for producing hunger and insulin resistance) is excluded. Thus the diet of the obese person gets altered, such that, over a period of 6 to 9 months, he naturally sheds much of the excess weight he has been carrying. Resolution of diabetes in most cases (and a major reduction in insulin resistance in some others) is a happy outcome of bariatric surgery. <---- Success Stories (click for more photographs and stories, opens in a new) window) |
Obesity Surgery is Not Liposuction or Cosmetic Surgery
More often than not bariatric surgery is confused with Liposuction. The two however are entirely different procedures. Liposuction is meant for body contouring and spot reduction of fat from certain areas of the body, while bariatric surgery, i.e. weight loss or obesity surgery is primarily meant for overall reduction of weight in an obese person.
Body Mass Index
A person is categorized as underweight, healthy weight, overweight, or obese based on his or her body mass index (BMI). Body mass index is a standardized measure of body fat that can be calculated based on an adult's height and weight. It is a measure for obesity in numbers.
When Not to Consider Bariaric Surgery
Bariatric surgery is not for everyone and no responsible surgeon will advise Bariatric surgery unless certain conditions, as per established guidelines, are met.
The National Institute of Health recommends that surgery be considered for people at the following weight levels:
Patients with a body mass index more than 40 (for Asians, greater than 35**)
Patients with a body mass index between 35 and 40 (for Asians, greater than 32 **) who also have serious medical problems (including diabetes, disabling joint conditions such as arthritis, or obstructive sleep apnea) that would improve with weight loss.
The New Guidelines for Asians:**
**(because people of Asian origin develop obesity related diseases, such as diabetes at much lower levels of overweight)
The National Institute of Health recommends that surgery be considered for people at the following weight levels:
Patients with a body mass index more than 40 (for Asians, greater than 35**)
Patients with a body mass index between 35 and 40 (for Asians, greater than 32 **) who also have serious medical problems (including diabetes, disabling joint conditions such as arthritis, or obstructive sleep apnea) that would improve with weight loss.
The New Guidelines for Asians:**
- Bariatric/gastrointestinal metabolic surgery should be considered as a treatment option for obesity in people with Asian ethnicity with BMI more than 35 with or without co-morbidities (associated diseases).
- Bariatric/gastrointestinal metabolic surgery should be considered as a treatment option for obesity in people with Asian ethnicity above a BMI of 32 with co-morbidities.
- Bariatric/gastrointestinal metabolic surgery should be considered as a treatment option for obesity in people with Asian ethnicity above a BMI of 30 if they have central obesity (waist circumference more than 80 cm in females and more than 90 cm in males) along with at least two of the additional criteria for metabolic syndrome: raised triglycerides, reduced HDL cholesterol levels, high blood pressure and raised fasting plasma glucose levels.
**(because people of Asian origin develop obesity related diseases, such as diabetes at much lower levels of overweight)
Advantages of Bariatric Surgery
Certain co-morbidities are known to improve/ get resolved with weight loss. These include:
Diabetes
Stress urinary incontinence
Lower back pain
Joints disease
Respiratory insufficiency
Sleep apnea syndrome
High blood pressure
High cholesterol
Asthma
Degenerative disk
Gastro-oesophageal reflux disease
Gall bladder disease
Diabetes
Stress urinary incontinence
Lower back pain
Joints disease
Respiratory insufficiency
Sleep apnea syndrome
High blood pressure
High cholesterol
Asthma
Degenerative disk
Gastro-oesophageal reflux disease
Gall bladder disease
Types of Weight Loss Surgery
Weight-loss surgery involves limiting the amount of food consumed by a person. Such surgeries can be of 3 types - restrictive, malabsorptive or a combination of the two.
Restrictive: Involves reducing the size of the stomach so that satiety is reached with eating very small meals.
Malabsorptive: Involves bypassing the part of the small intestine so that there is less opportunity for the calories from food to be absorbed.
Depending on patient's condition and requirement, one of the 3 types of bariatric surgeries may be recommended:
Laparoscopic Gastric Plication
Stomach tube is plicated and reduced in size, thus limiting the intake of food. it is a low cost, reversible, restrictive procedure. it has the same weight loss effect as any other restrictive surgery operation and also the resolution of co-morbidities.
Laparoscopic Sleeve Gastrectomy
Stomach tube is reduced in size, thus limiting the intake of food. The portion of stomach which secretes Ghrelin (the hormone causing hunger and insulin resistance) is removed.
Now also done by Single Incision (Scarless) surgery.
Laparoscopic Roux en Y Gastric Bypass
The size of the stomach is reduced to restrict food intake. The portion of stomach which secretes Ghrelin (the hormone causing hunger and insulin resistance) is removed. A portion of small bowel is bypassed, thus delaying food from mixing with digestive juices to avoid complete calorie absorption.
Laparoscopic Adjustable Gastric Band
A band is placed around the upper part of the stomach separating the stomach into one small and one large portion.
For a more information and a detailed discussion Dr. Ahsan Badar can be contacted on +919923796471 or via email at drabadar@gmail.com.
Dr Ahsan Badar's Academic and Medical profile can be checked out on clicking the link.
Dr. Ahsan Badar's surgical portfolio available on this link.
Restrictive: Involves reducing the size of the stomach so that satiety is reached with eating very small meals.
Malabsorptive: Involves bypassing the part of the small intestine so that there is less opportunity for the calories from food to be absorbed.
Depending on patient's condition and requirement, one of the 3 types of bariatric surgeries may be recommended:
Laparoscopic Gastric Plication
Stomach tube is plicated and reduced in size, thus limiting the intake of food. it is a low cost, reversible, restrictive procedure. it has the same weight loss effect as any other restrictive surgery operation and also the resolution of co-morbidities.
Laparoscopic Sleeve Gastrectomy
Stomach tube is reduced in size, thus limiting the intake of food. The portion of stomach which secretes Ghrelin (the hormone causing hunger and insulin resistance) is removed.
Now also done by Single Incision (Scarless) surgery.
Laparoscopic Roux en Y Gastric Bypass
The size of the stomach is reduced to restrict food intake. The portion of stomach which secretes Ghrelin (the hormone causing hunger and insulin resistance) is removed. A portion of small bowel is bypassed, thus delaying food from mixing with digestive juices to avoid complete calorie absorption.
Laparoscopic Adjustable Gastric Band
A band is placed around the upper part of the stomach separating the stomach into one small and one large portion.
For a more information and a detailed discussion Dr. Ahsan Badar can be contacted on +919923796471 or via email at drabadar@gmail.com.
Dr Ahsan Badar's Academic and Medical profile can be checked out on clicking the link.
Dr. Ahsan Badar's surgical portfolio available on this link.