WHAT IS OBESITY ?
Obesity results from the excess accumulation of fat that exceeds the body's skeletal and physical standards. But this obesity becomes "morbid" when it reaches the point of significantly increasing the risk of one or more obesity-related health conditions or serious diseases that result in significant physical disability. Morbid obesity is typically defined as being 100 pounds or more over the idea body weight or having a Body Mass Index (BMI) of 35 or more.

WHAT CAUSES MORBID OBESITY ?
The causes for obesity are multiple and complex. It is not simply a result of over eating always, it is also genetic. But whatever maybe the cause, the control of excess weight is something patients must work at for their entire life. Surgery for Obesity (Bariatric Surgery) should not be considered as a medical cure but should be seen as an attempt to reduce the effects of excessive weight and alleviate the serious physical, emotional and social consequences of the disease.

SIGNIFICANT OBESITY RELATED HEALTH CONDITIONS :
Obesity related health conditions can significantly reduce one's life's expectancy. Some of the most common conditions are :

Diabetes : Obese individuals develop a resistance to the insulin that regulates blood sugar levels which can cause serious damage over a period of time.

High blood pressure/heart disease : Excess body weight strains the ability of the heart to function properly.

Osteoarthritis of weight-bearing joints : The additional weight placed on joints, particularly knees and hips, results in excessive wear and tear with pain caused by inflammation. Similarly, bones and muscles of the back are constantly strained resulting in disc injury.

Sleep apnea/respiratory problems : Fat deposits in the tongue and neck can cause intermittent obstruction of the air passage, thus resulting in loss of sleep.

Gastric Reflux/heartburn : This happens when the acid which belongs to the stomach escapes into the esophagus through a weak or overloaded valve at the top of the stomach. Over a period of time, this may lead to further complications.

Infertility : The inability or diminished ability to conceive.

Fatty liver : Is caused by the accumulation of fat in the liver cells resulting in development of liver inflammation, fibrosis or cirrhosis.
Pulmonary embolism : This is caused by a clot from the venous circulation which originate in the lower extremities, known as Deep Vein Thrombosis (DVT). This is most prevalent in obese patients.

Venous statis : Heart or kidney disease brought on by excessive weight may also result in a condition known as venous statis that affects the proper function of the veins in the legs that would normally carry blood back towards the heart. The common result is swelling in the lower legs and ankles.


Surgery for Obesity (Bariatric Surgery)
A SERIOUS APPROACH TO A SERIOUS PROBLEM
Surgery for Obesity (Bariatric Surgery) is a major surgery. A procedure will be considered for someone with a BMI of 35 or higher if the doctor determines that obesity-related health conditions have resulted in a medical need for weight reduction through surgery. There has to be clearly understand amongst the patients of the extensive dietary, exercise and medical guidelines that must be followed for the remainder of their lives after having the Surgery for Obesity (Bariatric Surgery). However, the surgery has been found to be effective in improving and controlling many obesity related health conditions. A comprehensive bariatric surgery data showed that patients who underwent a bariatric surgical procedure experienced improvement of their co-morbid conditions including diabetes, hypertension and obstructive sleep apnea. In fact, diabetic patients have demonstrated excellent resolution of their diabetic condition to the point of having little or no need for continuing medication.

DIFFERENT KINDS OF ANTI OBESITY SURGERIES :
ABDOMINOPLASTY :

Abdominoplasty or 'tummy tuck" procedureis meant for persons with flabby belly associated with or without a hernia. By this method about 7-8Kg of fatty tissue is knocked off and any associated hernia is also repaired. We have done a whopping 700-800 of these procedures in the last 9 years with fabulous results. The patients have to stay in for 7-10 days, but are uniformly happy with the flattening of the lower abdomen.

LIPOSUCTION :

Liposuction, is less invasive and done by sucking out the fat from arms, thighs, buttocks and lower abdomen after melting it through tiny holes. Here, the accent is not on weight loss, but on contouring the body surface by reducing excess fat from a few sites. The advantage is, that it is almost a Day care Procedure, with discharge by evening or the next morning. Again the weight loss will be in the range of 6 - 8Kg. with very early recovery.

BARIATRIC SURGERY :

The most popular and effective surgery of all times. At the Lifeline Group of Hospitals, Chennai under the stewardship of Dr. J.S. Rajkumar, chairman and Chief Surgeon, Lifeline Group of Hospitals, various procedures have been performed for eg. Vertical banded Gastroplasty, ProRing or Long Roux-en-Y gastrojejunal anastomosis for persons who are morbidly obese or who have BMI > 35 with other health risk factors / problems.

The first of its kind was done by our team in September 2003. Vertical Banded Gastroplasty is done to reduce the capacity of the stomach to 50 - 100ml with the help of a stapler. In this procedure, the upper stomach near the esophagus is stapled vertically to create a small stomach pouch. The outlet from the pouch is restricted by a band or a ring that slows the emptying of the food, helping to create the feeling of fullness. In the next few months, they start losing weight in the range of 30 - 40Kg easily. Pro Ring has the same principle except that we use a pro-ring in place of Band.

Roux-en-Y Gastric bypass, is considered to be the most effective procedure for Surgery for Obesity (Bariatric Surgery). In this procedure, the stapling creates a small ( 15 to 20cc ) stomach pouch. The remainder of the stomach is not removed but completely stapled shut and divided from the lower stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption and the deodenum. This is done by dividing the small intestine just beyond the deodenum and constructing a connection with new, smaller stomach pouch. The weight loss in this type of procedure is more than the previous two procedures. It is important to choose the right patient for the right procedure and thereby the final result is satisfactory for both the parties. But it is fitting to say that "Anti Obesity Surgery" is coming to stay in a big way in our population.

HOW ARE THESE SURGERIES PERFORMED?
All the Bariatric surgeries are performed laparoscopically which has become a pre-dominant technique with most surgeons. This approach is considered less-invasive because just a few small incisions are made, replacing the need for one long incision to open the abdomen. Patient undergoing this surgery experience less pain after surgery resulting in easier breathing and lung function and higher oxygen levels. These patients return more quickly to pre-surgical levels of activity.

HOSPITAL STAY AND LIFE AFTER THE SURGERY

Most patients stay in the hospital for about 5 days and will be discharged once he/she is comfortable and are able to move about without any difficulty.

Patients have a new found confidence and most of their co-morbidities are reversed. Their quality of life zooms up They enjoy doing things they were unable to do earlier.

They can, walk, run and exercise as much as they want to. They no longer have to pay large amounts for drugs……and more than anything else, they can shop for regular clothes in a shop !!!!! Is not that exciting enough ???

OUR OBESITY CLINIC
We have a well equipped Obesity Clinic with a multi-disciplinary approach to Obesity problems. When you walk into our Obesity Clinic, you will be first assessed by a Nutrition therapist who will assess your food habits and other nutritional related mattes A General Physician will then examine you for medical associated diseases . A complete cardio work up will be done by the Cardiologist to rule out any cardio-related problem. Finally, an endocrinologist will assess you before you meet the Chief Surgeon who will be operating on you.

Before the surgery, you will be counselled about the surgery, its intricacies, length of your hospital stay, your recovery process and so on. Once you are discharged from the hospital, you will be asked to report every week on your status and how you are feeling. Duty doctors will be available round the clock if you need to consult them. You will also be given periodical nutritional counselling about what you eat, how you eat and so on.

We are the largest Obesity Clinic in South India and have performed more than 50 surgeries as of date.