If you’re struggling with your weight, you’re not alone. More than one-thirds of Indians are currently overweight or obese and many have medical conditions that affect their weight. Some have tried various diets and fitness programs with little or no success. With so much available nutrition and weight loss information, most people don’t know what are the scientific and safe medical options to achieve a healthy sustainable weight.
What is obesity
Obesity is not just about extra fat in body. It is a complex disorder of multiple etiologies characterized by excess body fat that threatens or affects not only physical and mental health but also has social and economic consequences. Obesity has been recognized as a “chronic disease” by number of health organisations across the world including “World Health Organization”.
How is obesity measured?
Obesity is measured with the help of two tools: BMI (Body mass index) and WC (Waist circumference). BMI is a tool calculated from a person’s height and weight, and used to analyse and determine whether he/she is overweight, underweight or health. BMI is calculated by dividing the weight (in kilograms) of a person by his height in meters squared.
That is, BMI = weight in kg/(height in m)2
As per the Indian standards, BMI more than 23 amounts to overweight and BMI more than 27.5 amounts to obesity.
Along with BMI, the distribution of body fat is very important. Waist circumference is a very good indicator of unhealthy fat (central obesity) in your body. For people of Indian origin, WC of more than 90 cm in men and more than 80 cm in case of women is abnormal.
How does obesity affect your health?
Obesity if left untreated can affect your health on numerous fronts. Some of the common problems related to obesity are type 2 diabetes, high blood pressure, high cholesterol, heart problems, fatty liver, chronic kidney disease, polycystic ovarian syndrome, infertility, gall stones, osteoarthritis, obstructive sleep apnea, benign intracranial hypertension, gastroesophageal reflux, urinary incontinence, repeated fungal infections of skin, depression, anxiety. Obesity is also a risk factor for variety of cancers.
About Comprehensive Weight Management Clinic (CWMC) at Fortis Hospital:
We are a medically-supervised and scientific evidence based weight management center and want to help you achieve a healthy sustainable weight. At CWMC we provide you a safe, non-judgmental, and helpful environment to talk about your weight. We are a “patient-centred” clinic, offering care that is based on best-practices in the area of obesity to ensure our patients are receiving the highest standard of care.
In order to provide the best possible care for our patients, the Comprehensive Weight Management Clinic (CWMC) has a diverse interdisciplinary team with experts in weight management from many different health care professions. Our team consists of a bariatric surgeon, an endocrinologist, a psychologist, registered dietitians, registered nurses, physiotherapist and most importantly, YOU. We also consult with other departments within Fortis Hospital (Cardiology, Pulmonology, Thrombosis and Anesthesiology) when a more specialized assessment is needed for our patients
What treatment options we offer?
Losing weight is not a one-size-fits-all journey. At the Comprehensive Weight Management Center, Fortis Hospital, we offer multiple tools to fit your lifestyle and weight loss needs. We offer weight loss solutions tailed to the individuals. We offer both medical and surgical options to lose and maintain weight. The medical program is led by an endocrinologist and the focus of this program is non-surgical treatment of obesity and obesity related health problems. The treatment options include:
- Lifestyle and behaviour modification program
- Partial meal replacement therapy
- Pharmacological therapy along with one of the above.
The Bariatric surgical program is led by our surgeon who performs bariatric surgeries in carefully selected candidates after thorough evaluation by the team.
What is Bariatric (Obesity) Surgery?
Bariatric surgery promotes weight loss by restricting food intake and, in some procedures, altering the digestive process. As with other treatments for obesity, the best results are achieved when combined with healthy eating behaviours and
regular physical activity.
Members of our interdisciplinary team complete both medical and psychological assessments on patients considering bariatric surgery because not everyone is an appropriate candidate for this surgery. Patients must be emotionally and physically ready for surgery because it requires significant lifestyle changes including taking vitamin supplements as well as adhering to dietary restrictions and routine physical activity.
How will Bariatric Surgery help you?
Bariatric surgery will help you
- Manage chronic medical conditions such as diabetes, high blood pressure, high cholesterol, sleep apnea and obesity.
- Improve your quality of life (better movement, physical and mental health, social activities, medications and overall well-being)
- Initially lose weight by reducing the amount of food you can consume and alter hunger/appetite cues (BUT permanent life changes are needed to maintain this)
- Identify challenges and build problem solving skills related to food, exercise, stress and mental health.
Who is eligible for Bariatric surgery ?
A person with BMI>40kg/m² or BMI>35kg/m² with for 2 or more co-morbid factors –
- Type 2 diabetes
- Refractory hypertension
- Obstructive sleep apnea
- Coronary artery disease
- Debilitating arthritis
Eligibility Criteria for Indian patients:
- BMI>37kg/m² or BMI>32.5kg/m² with for 2 or more co-morbid factors
- Have failed 6 months of organized attempts at weight management, as determined by their primary care provider
- Have attained or nearly attained physiologic maturity
- Be very severely obese (BMI >40) with serious obesity-related comorbidities or have a BMI of >50 with less severe comorbidities
- Agree to avoid pregnancy for at least 1 year postoperatively
- Be capable of and willing to adhere to nutritional guidelines postoperatively
Laparoscopic Sleeve Gastrectomy
Laparoscopic Sleeve Gastrectomy is a restrictive procedure, which involves removal of 60-75% of the stomach, leaving a narrow gastric tube or sleeve. No intestines are removed or bypassed. This procedure will result in approximately a 50% loss of excess body weight in the first 6-12 months.
Roux-EN-Y is a laparoscopic surgical procedure that combines restrictive and malabsorptive components. It decreases the size of the stomach to about one-ounce capacity and bypasses part of the small intestine to decrease absorption. This is the most commonly performed weight loss surgery and you can expect to lose about 80% of your excess body weight within 12 months
The mini-gastric bypass procedure has gained popularity in recent years.The mini-gastric bypass procedure is restrictive and malabsorptive. This means that the procedure reduces the size of your stomach, restricting the amount you can eat. The procedure also reduces absorption of food by bypassing up to 6 feet of intestines. Mini-gastric bypass is a quicker operation compared to traditional laparoscopic gastric bypass surgery. Operating times are reduced, on average by 50 minutes.