Obesity
Obesity
Obesity is a leading cause of morbidity and mortality worldwide. Morbid obesity is described as Body Mass Index (BMI) of > 35. BMI is calculated by dividing weight in kilograms divided by the square of height in meters. You can calculate your BMI here.
Am I obese?
| BMI | |
|---|---|
| 18.5 to 24.9 | Healthy |
| 25 to 29.9 | Overweight |
| 30 to 39.9 | Obese |
| > 40 | Severly Obese |
Why should I be worried?
Obesity can lead to a number of health problems. Some of them are due to physical stress of carrying extra weight. These include back and knee & hip pain. Obesity can lead to knee and hip arthritis and can impair mobility. This can stop you from being physically active, which in turn doesn’t help in your efforts to lose weight.
The effects of obesity can be more profound. In fact it is very well know that being obese makes you more likely to develop diabetes and high blood pressure. These two in turn increase the chances of you developing serious health problems like heart attacks and strokes. This effect of obesity on your body is called ‘metabolic syndrome’, which means that obesity somehow changes your metabolism and makes you prone a number of serious illnesses.
It is also well known that being obese impairs your menstrual periods. It isn’t uncommon that obese women to have irregular periods. More importantly, obesity can affect fertility making it harder to conceive children.
There is also emerging evidence that obesity can lead to higher chances of developing cancers such a breast and bowel cancers.
Does dieting work? Why can't I diet and lose weight?
Dieting certainly works. Good healthy protein rich diet coupled with good physical activity certainly helps you to lose weight. After a certain weight / BMI, many patients manage to lose good amount of weight by dieting alone. But unfortunately, most of the times they put the weight back on and more.
To demonstrate why, the following example of a patient that Mr Jayanthi has operated on.
| Height | 5ft 9 inch |
| Weight | 27.5 stones |
| BMI | 56.8 |
| >Body weight at BMI of 25 | 12 stones |
| >Excess Body Weight | 15.3 stones |
As you can see from the above table, this patient is carrying an excess weight that is more than his normal weight. Therefore, this patient is carrying themselves and another person. Therefore, this patient would need to eat twice as many calories, even just to carry out day to day activities. If this patient starts dieting, he will be constantly hungry, and the diet will not be sustainable.
Gut hormones
Moreover, the patients’ gut hormones (hormones secreted by the gut) will be abnormal. In an obese patient, over the time, the hunger hormones (hormones that tell your brain that you are hungry and need to eat) are turned up. While the satiety hormones (hormones that tell your brain that you have had enough to eat) are turned down. These changes make it even harder to lose weight by dieting alone.
Bariatric Surgery is proven to be a safe and effective way to lose weight. More importantly sustain the weight loss and improve quality of life. Surgery for obesity is now proven to improve conditions such as Diabetes, High Blood Pressure, Arthritis and many other obesity related health problems.
FAQs
If BMI is above 40 or above 35 with obesity related health problems, you are suitable for surgery. There is emerging evidence that surgery is beneficial for patients with lesser BMI.
The operation works with a combination of decreasing the size of the stomach along with changes in your gut hormones.
This depends on a number of issues. An ideal operation would result in effective & sustained weight loss with minimal risks and side effects. Mr Jayanthi, will have a detailed discussion about your health, expectations and the most suitable operation for you.
Mr Jayanthi, is experienced in a wide range of operations (including Gastric bypass & Sleeve gastrectomy) and also performs revisional bariatric surgery. Therefore, you can discuss various options and mutually decide on the most suitable operation.
Mr Jayanthi deals with a number of such patients. Bariatric operations can fail or give you new symptoms for a variety of reasons. Treating these can be sometimes difficult and you might need more investigations before deciding on a solution. Therefore a consultation would be the first step to understand the situation, plan investigations and treatment.