Verified By June 12, 2019
2315Obesity is abnormal accumulation of body fat, usually 20% or more over an individual’s ideal body weight. It is defined as Body Mass Index (BMI) equal or more than 30. BMI is calculated as the ratio of body weight in kg to square of height in meters. There are other ways of measuring obesity like fat thickness, waist circumference.
The incidence of obesity is increasing day to day. “In every region of the world, obesity doubled between 1980 and 2008,” As per WHO’s The World health statistics 2012 report, Today one in six adults that is, half a billion people (12% of the world’s population) are considered obese.” Though India is a developing country with malnourishment, now a days India is gaining weight. Obesity has reached epidemic proportions in India in the 21st century, with morbid obesity affecting 5% of the country’s population. It is more prevalent in urban population & females.
Studies show that in India, nearly 15 to 20% of children are overweight and 30% are in the risk of falling in this category. It is these statistics that ring major alarm bells. In India, many studies have shown that the prevalence of overweight among adolescents varies between 10% and 30%. Another important concern is that as high as 60 to 70% may continue to be overweight or obese in adulthood.
https://youtu.be/IgUbjOOqzEo
Under weight | <19 |
Ideal | 19-25 |
Over weight | 25-30 |
Obese | >30 |
Severely obese | >35 |
Morbid obese | >40 |
Super obese | >50 |
Obesity has its deleterious effects on all systems such as Respiratory disease, Stroke, Cardiovascular problems, Gall stone disease, Gout, Osteoarthritis, Hormonal abnormalities, Diabetes & Cancer. Diabetes and obesity are mutually related. India is diabetes capital of the world. 40.9 million people are diabetic in India, this is expected to rise to 69.9 million by 2025.
Glucose maintenance in the body is a complex process. Whenever food enters the system glucose needs to be absorbed into cells by insulin. Secretion of insulin is helped by incretins which are the substances produced by hind gut that stimulate the Beta cells to produce insulin. Secretion of insulin inhibited by anti incretins secreted by fore gut. Poor sugar control is the major contribute for the development of Diabetes which is due to excessive calorie intake, poor secretion of insulin, insulin resistance. All these are strongly associated with obesity.
Obesity management is a multidisciplinary approach with several modalities like conservative, medical, non surgical, minimally invasive & major surgical approaches.
Conservative approach is the base line primary modality achieved through changing dietary habits, life style. This will certainly help in early phases of obesity but requires a lot of dedication, commitment.
Medical management mainly targets on inducing early satiety.
Non surgical methods are Gastric balloon which will be placed endoscopically. It is useful when BMI is 25-30.
Surgical approach is well known as Bariatric or Weight reduction surgery. Most people are not successful losing weight with diets. As someone becomes overweight, the risk of developing other serious diseases dramatically increases. Surgery has proven to be the most effective method to treat severe obesity. Surgery is of choice when both conservative & medical management fails.
In Indian scenario with difficult long term follow up, regular additional nutrition, mineral, vitamin supplementation, Laparoscopic Sleeve Gastrectomy is effective weight reduction surgery for obese. There won’t be any major anatomical, functional alteration of digestive tract & with almost nil post operative morbidity & mortality. Studies also suggested that weight reduction following sleeve gastrectomy is as equal as of with gastric bypass.
Sleeve gastrectomy is a restrictive procedure. It greatly reduces the size of the stomach and limits the amount of food that can be eaten at one time. It does not cause decreased absorption of nutrients or bypass the intestines. After this surgery, patients feel full after eating very small amounts of food. Sleeve gastrectomy may also cause a decrease in appetite. In addition to reducing the size of the stomach, the procedure reduces the amount of the “hunger hormone,” ghrelin, produced by the stomach. The duration of this effect is not clear yet, but most patients have significantly decreased hunger after the operation.
Postoperatively patients monitored as like any other laparoscopic surgery. 2nd post operative day contrast scan can be performed to see any contrast leak followed by patients will be started liquid diet as tolerated and can be discharged on the same day. Further follow up will be after a week and diet will be gradually increased from clear liquid to full liquids and to soft diet as tolerated under guidance of experienced dietician.
At APOLLO, we perform Laparoscopic sleeve gastrectomy as a multidisciplinary team with well trained and qualified laparoscopic and bariatric surgeons, high end anaesthesiologists, well trained ot staff including nurses and technicians and good quality equipment, ICU set up as back up if necessary, dieticians, psychologists and behavioural therapists and fitness experts on a regular basis and achieving effective & satisfactory results. Our patients usually discharge on 2nd post operative day with liquid diet. And patients are back to work in less than a week. We have seen effective weight loss of around 60% percentile in 6 months without major nutritional disturbances. However, bariatric surgery is not a resort in cases of childhood obesity because the child needs to attain his full growth potential until the age of 18 and so as to not interfere with normal growth physiology
A gastric sleeve surgery takes anywhere between 1.5 to 3 hours.
3-5 days.
One should be able to work and resume all normal activities in 2 weeks, and full recovery can be expected in 30 days.
75%
Maximum weight loss is seen in the first 10 months and one can expect to lose
upto 21% weight by the third year.
Gastric sleeve requires no readjustments and therefore no reoperations. Also, the fullness produced is more satisfying than the feeling of obstruction caused by banding.
A gastric sleeve does not involve any rerouting and is hence faster, easier and safer. Also, there are no vitamin and mineral deficiencies.
Dr.Rajnesh C. Reddy
Surgical Gastroenterologist,Laparoscopic surgeon Senior Consultant
Apollo Health City
To book appointments with the finest bariatric surgeon visit the link below:
General Surgery & Laproscopic Surgeon in Kanpur
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