ELCE Obesity Clinics

What is obesity?

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to reduced life expectancy and/or increased health problems.

What is body mass index or BMI? How obesity is been classified based on BMI?

BMI = Weight (in kgs) / Height square (in Mtrs)

Why there is difference in BMI between asians and other countries?

Increases in weight over time were more harmful in Asians than in the other ethnic groups: For every 5Kgs Asians gained during adulthood, they had an 84 percent increase in their risk of type 2 diabetes; Several other studies have found that at the same BMI, Asians have higher risks of hypertension and cardiovascular disease than their white European counterparts, and a higher risk of dying early from cardiovascular disease or any cause.

One possible explanation is body fat. When compared to white Europeans of the same BMI, Asians have 3 to 5 percent higher total body fat. South Asians, in particular, have especially high levels of body fat and are more prone to developing abdominal obesity, which may account for their very high risk of type 2 diabetes and cardiovascular disease.

What is the main cause of obesity?

A lack of energy balance most often causes overweight and obesity. Energy balance means that your energy IN equals your energy OUT. Energy IN is the amount of energy or calories you get from food and drinks. Energy OUT is the amount of energy your body uses for things like breathing, digesting, and being physically active.

  • An Inactive Lifestyle
  • Environment
  • Genes and Family History
  • Health Conditions
  • Medicines
  • Emotional Factors
  • Smoking
  • Age
  • Pregnancy
  • Lack of Sleep

What are the health risks of obesity?

Being obese puts you at risk for a number of preventable diseases and conditions, including heart disease.

  • Type 2 Diabetes
  • High Blood Pressure
  • Stroke
  • Gallbladder Disease
  • Breathing Problems
  • Certain Types Of Cancer
  • Chronic Back Pain
  • Osteoarthritis

Obesity may also take a toll on self-esteem and contribute to depression. One of the health risks associated with being overweight or obese is metabolic syndrome. Obesity can damage a person’s fertility. Carrying excess weight can make it difficult for a woman to become pregnant and for a man to produce adequate amounts of healthy sperm.

Why is obesity a growing problem?

Obesity is spreading in many countries because of changes in the way we live, work, and play. Many of our jobs have become less physically demanding, but we seem to have less and less time available to devote to physical activity and exercise. We drive more and walk less. We spend many more hours in sitting in front of screens – watching television, playing video games, browsing the internet, or engaging with our mobile devices than doing some active work. Our habits around food have changed, too, as we eat bigger and bigger portions of less healthful foods.

Why is obesity a growing problem?

Obesity treatment is multi-faceted and involves making changes in eating habits and activity levels. It also involves becoming more educated about the risks of obesity. A doctor needs to investigate potential risks, complications, and underlying health conditions that may require treatment.

  • Healthy eating habits
  • Balancing physical activity
  • Behavioral modification to adopt healthy life style
  • For more obese patients who have obesity related other health problems Surgery will be the option of treatment.

What are the types of surgical choices available for obesity?

Procedures for weight loss are either restrictive (sleeve gastrectomy) and /or malabsorptive (Gastric Bypass) based on changing the size of stomach or altering the food absorption pathway by bypassing. They restrict the intake of food and/or cause some of the food to be poorly digested and absorbed, and therefore eliminated in the stool.

Surgery has become an acceptable method of treatment for clinically severe obesity because it appears to be the only option which can provide long-term maintained weight loss in-patients with clinically severe obesity. In fact, the number of patients having surgical treatment of obesity has increased several folds in recent years. Stomach, or gastric operations, have been preformed since 1969.

What are the differences between open and Laparoscopic weight reduction surgeries?

Compared to Open surgeries Laparoscopic surgeries are been done with much small incisions.

So the Operative scars and post operative pain will be very little. Chances of getting Incisional Hernia is very less as well. Blood loss during the procedure will be very minimal. Since the operative wound is very small patient can return back to the routine in very few days.

How does Bariatric Surgery Work?

Bariatric surgery, such as gastric bypass, and gastric sleeve work by changing the anatomy of your gastrointestinal tract (stomach and digestive system) or by causing different physiologic changes in your body that change your energy balance and fat metabolism.

Regardless of which bariatric surgery procedure you and your surgeon decide is best for you, it is important to remember that bariatric surgery is a ❛tool❜. Weight loss success also depends on many other important factors, such as nutrition, exercise, behavior modification, and more.

By changing your gastrointestinal anatomy, certain bariatric procedures affect the production of intestinal hormones in a way that reduces hunger and appetite and increases feelings of fullness (satiety). The end result is reduction in the desire to eat and in the frequency of eating. Interestingly, these surgically-induced changes in hormones are opposite to those produced by dietary weight loss. Let’s take a closer look at the differences in hormonal changes between surgery and dietary weight loss.

Dieting and Hormonal Changes Bariatric Surgery and Hormonal Changes. In dietary weight loss, energy expenditure is reduced to levels lower than would be predicted by weight loss and changes in body composition. This unbalanced change in energy can often lead to weight regain.

Hormonal changes following bariatric surgery improve weight loss by maintaining or enhancing energy expenditure (calories burned). In fact, some surgeries even increase energy expenditure relative to changes in body size. Thus, unlike dietary weight loss, surgical weight loss has a higher chance of lasting because an appropriate energy balance is created.

Am I a candidate for surgery to lose weight?

  • Weight greater than 45kg above the ideal body weight for sex, and height (Ideal body weight = height {cms}-100).
  • BMI > 35 by itself or >30 if there is an associated co-morbidities like hypertension, diabetes, cordiac illness or life style restrictions because of knee pain and sleep apnoea.
  • Reasonable attempts at other weight loss techniques.
  • Obesity related health problems.
  • No psychiatric or drug dependency problems.
  • A capacity to understand the risks and commitment associated with the surgery.
  • Pregnancy not anticipated in the first two years following surgery.

What are the other benefits one can get apart from weight reduction followed by weight reduction surgery?

Bariatric surgery is associated with massive weight-loss and improves, or even resolves (cures), obesity-related co-morbidities for the majority of patients. These co-morbidities include high blood pressure, sleep apnea, asthma and other obesity-related breathing disorders, arthritis, lipid (cholesterol) abnormalities, gastroesophageal reflux disease, fatty liver disease, venous stasis, urinary stress incontinence, pseudotumor cerebri, and more.

High Blood pressure, Diabetes, Dyslipidemia if not treated properly may lead to some of the following:

  • Coronary artery disease.
  • Heart attack.
  • Irregular heartbeats.
  • Heart disease.
  • Stroke.
  • Kidney damage.
  • Vision loss.
  • Amputations.
  • Varicose veins.
  1. Diabetes improves in more than 85% and remission of the disease in 78%.
  2. High Blood Pressure Resolves 75.4%.
  3. High Cholesterol Improves more than 95%.
  4. Obstructive Sleep Apnea resolves more than 86.6%.

Due to low oxygen levels in blood People with obstructive sleep apnea are at risk for:

  • Heart disease.
  • High blood pressure.
  • Heart attack.
  • Kidney Disease.
  1. Acid Reflux/GERD resolved in 98%.

People with acid reflux are at risk for developing:

  • Esophagitis, inflammation of the esophagus, which can cause difficulty swallowing, ulcers, and scarring.
  • Barrett’s esophagus which occurs because the lining of the esophagus is damaged by stomach acid and can lead to esophageal cancer.
  • Esophageal cancer (adenocarcinoma) is associated with a low survival rate: only 12% of esophageal cancer patients survive for more than five years.

In 2001, experts at the National Cancer Institute concluded that several cancers are associated with obesity:

  • Colon Cancer.
  • Breast Cancer.
  • Esophageal Cancer.
  • Liver Cancer.
  • Pancreatic Cancer.
  • Multiple Myeloma.
  • Uterine Cancer.

In 2003, an article in the New England Journal of Medicine estimated that obesity could account for:

  • 14% of all deaths from cancer in men.
  • 20% of all deaths from cancer in women.
  1. Bariatric surgery improves life expectancy in patients with cancer by at least 29 to 89%.
  2. Depression improves in 47%.
  3. Osteoarthritis and Joint Pain resolves in 41%.
  4. Stress Urinary Incontinence Resolves in 44%.
  5. Menstrual Dysfunction Due to Polycystic Ovarian Syndrome Resolves in 95-100%.
  6. Excess Hair Due to Polycystic Ovarian Syndrome Resolved in 79%.
  7. 57% of patients experienced complete resolution of migraine.
  8. 95% of patients experienced complete resolution of venous stasis disease.

How does Bariatric Surgery Work?

Weight Reduction surgeries are elective and requires a team work concept. So that a patient gets comprehensive Education, treatment and follow up.

ELCE Obesity clinics comprises of

  • Bariatric Surgeon Dr. P.S.Rajan.
  • Medical Educator.
  • Dietician.
  • Psychological Counsellor.
  • Physiotherapist.
  • Support groups.

to ensure Recovery, Life style modification and readjustment to a newer life.