Obesity: Newer ways of treatment and solutions

By Dr R Padmakumar| Express News Service | Published: 11th September 2018 11:21 PM

KOCHI: Nowadays everyone wishes to have an attractive body figure. Today a great majority of the population are dependent on various methods for reducing body weight. Modern medicines have come up with good permanent techniques by which body weight, as well as the abdominal fat, can be reduced. These are surgical measures using laparoscope.

The Body Mass Index (BMI) is an estimate in relation to the weight and height of a person. It is calculated as weight in kilogram divided by height 2 times (BMI = Weight in Kg/ height in M2). BMI of 20 to 25 is considered normal.  BMI of 26 to 30 is overweight.  Above 30 is obesity and above 37 is considered as morbid obesity.

Reasons for obesity

Though hereditary factors can cause obesity, it is usually by the excessive intake of food that are rich in fat and low in fibre Meat sweats in excess quantity and repeated intake of food causes obesity.  Soft drinks, instead of ordinary water also contribute.

After-effects

When weight increases, it directly affects the heart and respiratory system.  It will result in a heart attack at a very early age. Cholesterol deposition causes a reduction in the lumen of blood vessels leading on to high BP (Hypertension). The chances of vascular events like heart attack and stroke are very very high due to the blockage of vessels in these patients. The requirement for coronary angioplasty and cardiac bypass are 3-4 fold compared to persons with normal weight.  Obesity also leads to sleep disorders and respiratory problems called sleep apnea.  

Solutions

Controlling the diet and increasing exercise will counter the problems.  Although various drugs are available in the market, they can reduce weight to a minimum extent only.  The permanent solution for obesity and related illness is surgery. As these procedures are done through laparoscopy, it is a thing which makes it comfortable, safe and simple for a patient.

Laparoscopy – Keyhole surgery

Laparoscopy is performed by making a one cm incision in the abdomen and inserting a telescope which is connected to the monitor outside through the incision and there are three types of laparoscopic procedure for obesity.

Sleeve gastrectomy

Using staplers a portion of the stomach is removed and thereby reduces the quantity of food the patient take additionally.   This reduces appetite, stimulating agents and acid secretions so that patient will be comfortable with a small quantity of food.  This is sure to bring down the weight of the patient drastically with desirable effects on existing illness.

Banding

In this, an adjustable band is placed around the stomach so that stomach size at the area of food entry is reduced.  The patient can adjust the size of stomach and quantity of food.

Gastric bypass

In this, the stomach is connected to a distal part of the intestine so that the absorption is reduced and thus causes weight reduction.  

Many studies have shown that surgery for obesity in addition to causing dramatic weight loss improves or resolve the condition associated with obesity.  The requirement for insulin is reduced to 90% and hypertension medication can be discontinued by almost 80% of persons.  The patient may require procedures like liposuction, lipectomy or abdominoplasty for cosmetic purpose.  


Dr R Padmakumar, Laparoscopic Surgeon, VPS Lakeshore Hospital (The views expressed by the author are his own )

More from this section

Harbour Terminus Station back to life from tomorrow
Awaiting a better season
KV alumni helps Chendamangalam weavers get back to their feet
Exploring the road less travelled
Beckoning backpackers to God's Own Country