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
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.
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
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
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
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
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 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, 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.
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
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.