Apollo Hospitals Group - Largest Healthcare Group in Asia

Bariatric Surgery

What is morbid obesity?
Obesity means having too much body fat (adipose tissue). Obesity is determined by calculating body mass index (BMI), which measures weight for height and is stated in numbers.
          Weight (in Kgs,)
BMI = ---------------------------------------------
         Height (in meters) X Height (in meters)

BMI              Status
Below 18.5    Underweight
18.5 – 24.9   Normal
25 – 29.9      Overweight
30 – 34.9      Obese
35 – 39.9      Severe Obesity
> 40             Morbid Obesity
> 50             Super morbid Obesity

HEALTH HAZARDS OF MORBID OBESITY

Severe obesity damages the body by its mechanical, metabolic and physiological adverse effects on normal bodily function. These "co-morbidities" affect nearly every organ in the body in some way, and produce serious secondary illnesses, which may also be life-threatening. The cumulative effect of these co-morbidities can interfere with a normal and productive life and can seriously shorten life as well. The risk of developing these medical problems is proportional to the degree of obesity.

People who are obese do not live as long as those who are not obese and the earlier a person become obese; the more years of life are lost.
Heart Disease- Severely obese persons are approximately 6 times as likely to develop heart disease as those who are normal-weighted. Heart disease is the leading cause of death today and obese persons tend to develop it earlier in life and it shortens their lives.
High Blood Pressure -Hypertension is much more common in obese persons and leads to development of heart disease, and damage to the blood vessels throughout the body, causing susceptibility to strokes, kidney damage, and hardening of the arteries.
Diabetes Mellitus - Overweight persons are 40 times as likely to develop Type-2, Adult-Onset, diabetes. Once Diabetes occurs, it becomes even harder to lose weight, because of hormone changes which cause the body to store fat even more than before.
Sleep Apnea Syndrome - Sleep apnea - the stoppage of breathing during sleep -- is commonly caused in the obese, by compression of the neck, closing the air passage to the lungs.
Respiratory Insufficiency
Heartburn - Reflux Disease and Reflux Nocturnal Aspiration
Asthma and Bronchitis
Gallbladder Disease -Gallbladder disease occurs several times more frequently in the obese, in part due to repeated efforts at dieting, which predispose to this problem.
Stress Urinary Incontinence.
Degenerative Disease of Lumbo-Sacral Spine (Backbone).
Degenerative Arthritis of Weight-Bearing Joints like knee, hip.
Venous Stasis Disease in the lower extremities.
Emotional / Psychological Illness- Seriously overweight persons face constant challenges to their emotions: repeated failure with dieting, disapproval from family and friends and remarks from strangers. They often experience discrimination at work. Stereotypes of obese people – such as that they are lazy – may result in lower self esteem and poor body image. There is no wonder that anxiety and depression might accompany years of suffering from the effects of a genetic condition -- one which skinny people all believe should be controlled easily by will power.
Social Effects - Severely obese persons suffer inability to qualify for many types of employment and tend to have higher rates of unemployment. There is a general societal belief that obesity is a consequence of a lack of self-discipline, or moral weakness.

TREATMENT OF MORBID OBESITY

The National Institutes of Health has held three conferences on surgery for severe obesity in the past 15 years. At the most recent conference, the panel of experts concluded that "reduced life expectancy and significant psychosocial and economic problems are experienced by severely obese people." They went on to say: "Limited success has been achieved with a variety of non-surgical approaches including medically supervised dieting. Diet alone cannot be considered a reasonable option for permanent weight loss surgery. Drug therapy for clinically severe obesity has been disappointing." SURGICAL OPTIONS FOR MORBID OBESITY

You have to seriously consider the surgical option for reducing weight to avoid its ill effects.

If your BMI is over 40.
If your BMI is 35 or higher and you have a serious medical problem (hypertension, diabetes, heart disease, joint problems, reflux) that is made worse by obesity
If you have been unable to reduce weight or maintain weight under a medically supervised program
You have been obese for at least 5 years

The panel endorsed two surgical treatments for obesity: GASTRIC BYPASS AND GASTRIC BANDING, noting that "significant weight loss usually occurs and a number of associated disorders (such as diabetes and hypertension, etc) often improve."

Gastric banding operations reduce the functional size of the stomach (with a gastric band, silastic ring or staples). This restricts the amount of food one can eat at one meal. By reducing the calorie intake, it causes weight loss.

Gastric bypass procedures go further. This type of surgery reduces the amount of eaten food that can be absorbed in the digestive tract. So not only does one eat less calories, but there is also less absorption of calories. This is why gastric bypass surgery tends to produce greater weight loss than other bariatric operations.