Saturday, 31 August 2013

Need of the Hour: Morbid Obesity Management

Overweight & Obesity are accumulation of excessive fat due to an imbalance between energy intake (food) and expenditure (activity). It is one of the most deadly & slow killer condition and involves almost all parts & system of body. Every disease becomes more severe in presence of obesity.

BMI is a tool calculated from person’s height and weight, and use to analyze and determine whether he/she is overweight, underweight or is healthy. BMI = Weight [kg] / Height [m^2]

Why should I worry about excessive weight?

Common complications or diseases due to obesity are:
· Heart Failure, Sleep Apnea, Coronary Artery Disease
· Type II Diabetes Mellitus Joint Problems - Arthritis, Gout
· Venous circulatory disease-Varicose veins
· Endocrine System Abnormalities
· Cardiovascular System- Hypertension,
· Gallbladder Diseases

Behavioural or Lifestyle Modification (Healthy Dieting & Exercise)

A few suggested behaviour modifications includes changing eating habits, increasing physical activity, engaging in a outdoor sports and extracurricular activity & setting realistic weight management goals. A moderate exercise for 30-60 min per day is recommended for weight reduction. A nutritionally balanced, low calorie, low fat diet is recommended for weight loss. It should also be high in fibre along with adequate amount of proteins, vitamins and minerals. Tips for healthy dieting are:
- Avoid Junk Foods 
- Avoid red meats
- Increase intake of fibre
 -Prefer whole-fruit to juices
- Limit intake of refined foods
- Increase intake of whole grain cereals 
-Reduce consumption of simple sugars
- Increase consumption of green leafy Vegs.


Liposuction is suitable for moderate obesity (BMI < 35 and preferably without any co-morbidities). Liposuction is the removal of excess fat deposit from the body through very tiny holes. It is frequently performed to reduce fat in the hips, thighs, abdomen, upper arms and other areas of fat deposits below the skin. The immediate benefits of liposuction can be both physical and mental. The greatest mental benefit is that the patient gains an incredible boost of self esteem due to greatly improved body image.

Body Contouring

Body contouring is combination of Liposuction, Abdominoplasty & sometimes belt lipectomy. It is very useful procedures in hanging type of obesity or hanging abdominal pouches, as seen in most of the obese middle aged Indian women, especially after multiple childbirths. A plastic surgeon can lift and reshape various parts of the body to create smoother, tighter contours like Arm Lift, Thigh Lift and Butt Lift.


Bariatric Surgery either limits the amount of food a patient can take (Restrictive) or reduce the ability of the patient to digest and absorb food (mal-absorptive). A third approach may be the combination of both.

1. Adjustable Gastric Banding (also known as the LAP-BAND)
2. Vertical Sleeve Gastrectomy (this is more advanced and frequently performed procedure)
3. Duodenal Switch/Biliopancreatic Diversion (BPD)
4. Roux-en-Y Gastric Bypass (RGB)

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