Obesity clinic

Obesity is one of the major lifestyle diseases affected all people regardless of age, gender, ethnicity. Obesity could lead to other health issues such as heart disease, diabetes, high blood pressure, and cancer. Recent studies illustrate that almost 135 million people are affected by obesity in India and it is one of the major risk factors for developing cardiovascular disease (CVDs). Interestingly, the prevalence of obesity is more in people who reside in cities and have high socio-economic status. The Obesity Clinic at Aster Medcity, Kochi offers person-centered treatment for obesity, the expert team comprises Dieticians, Endocrinologists, and Gastroenterologists.

What is Obesity?

Obesity is a complex disease characterized by abnormal or excessive accumulation of fat in the body that may impair health. People who have obesity are prone to develop heart disease, diabetes, high blood pressure, and cancer.

How obesity can be identified?

The ideal way to measure obesity is by calculating the Body mass index (BMI) of a person. BMI is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2). Increased BMI shows high body fatness. The BMI scale for adults given below,

What are the causes of Obesity?

The primary cause of obesity is the energy imbalance between calories consumed and calories expended. Overweightness is commonly caused by overeating and a sedentary lifestyle. For instance, if you consume high amounts of energy, particularly fat and sugars, but do not burn off the energy through exercise and physical activity, much of the surplus energy will be stored by the body as fat.

Factors that can lead to obesity are,

• Increased intake of energy-dense foods that are high in fat and sugars
• Decrease in physical activity due to the increasingly sedentary nature of work
• Environmental and societal changes associated with the development
• Lack of supportive policies in health, agriculture, environment, food processing, and education
• Diseases – Hypothyroidism, Chronic stress, Insomnia & Hypersomnia
• Eating Disorders
• Smoking cessation
• Drugs

Do Genetic reasons cause obesity?

Genetic predisposition is one of the reasons for obesity, it is a well-known and currently proven fact. Around 43% of the general population is susceptible to become obese due to genetic factors.

What are the diseases associated with obesity?

There are several ailments associated with overweightness, an obese person has more chance to develop other disease conditions such as,

• Cardiovascular diseases - Ischemic Heart Disease and Stroke
• Hypertension
• Insulin Resistance & Diabetes Mellitus
• Dyslipidaemia
• Obstructive Sleep Apnoea & Hypoventilation Syndrome
• Nonalcoholic fatty liver disease - NASH – CLD
• Gallbladder disorders
• PCOS & Infertility
• Musculoskeletal disorders - Osteoarthritis
• Cancers - Endometrium, Breast, Kidney, Liver, Prostate, Esophagus, Colon.
• Psychological disorders.

The risk for these diseases increases with an increase in BMI.

Is obesity curable?

Obesity is a progressive and relapsing chronic disease that can be either prevented or reduced by losing weight by following a healthy dietary pattern and regular regimen of exercise.

What are the treatments available for obesity?

The aim of the obesity treatment is to maintain a healthy Body mass index (BMI) to prevent many other diseases associated with obesity. Following a healthy dietary pattern and regular physical activity helps in sustaining overall health.

Non-Surgical Options

• Physical activity

Doing exercise is an important part of obesity treatment, it can be anything from a brisk walk to aerobic exercises. You are advised to exercise at least 5 hours in a week.

• Nutrition Therapy

At Aster Medcity, Kochi, the dedicated team of Dieticians, Endocrinologists and Gastroenterologists will help you to follow a tailored dietary plan upon conducting a detailed study based on your existing dietary habits, lifestyle, age, body mass index. Nutrition therapy would help you to make healthier choices to keep a good body mass index.

• Pharmacotherapy

Drugs like Orlistat, Lorcaserin, and Liraglutide are proven to be very effective in managing obesity.

• Endoscopic treatments

Your doctor may suggest Endoscopic bariatric and metabolic therapies (EBMTs) as a treatment of obesity. There are mainly two options

• Gastric balloon placement

An intragastric balloon is kept in the stomach to slow down gastric emptying and leads to a feeling of fullness.

• Endoscopic sleeve gastroplasty (ESG)

Endoscopic sleeve gastroplasty is an option for you if the BMI is 30 or more and other lifestyle modification treatments have failed. ESG is a minimally invasive procedure to facilitate weight loss, a suturing device is introduced into the stomach via the throat, sutures are placed in your stomach to make it smaller.

Surgical Options (bariatric surgery)

• A laparoscopic adjustable gastric band (LAGB)

This is a laparoscopic surgery to create a small stomach pouch with the help of small incisions in the abdomen. The small stomach pouch makes the patient to experience a feeling of fullness which aids weight loss.

• Laparoscopic sleeve gastrectomy (LSG)

This is a short, safe laparoscopic surgery to reduce the size of your stomach, the goal of this procedure is to limit the quantity of food taken at one time. In Laparoscopic Sleeve gastrectomy 70% of the stomach is removed and a narrow sleeve is created. This procedure doesn’t involve bypassing or removal of the intestine and hence causes only minimal nutritional disturbances.

• Biliopancreatic diversion

In this procedure, a banana-shaped stomach tube is created by removing 80% of the stomach. Biliopancreatic diversion is done with or without duodenal switch (BPD-DS) and with or without LSG (ie. staged BPD)

• Roux-en-Y gastric bypass (RYGB)

Roux-en-Y gastric bypass (RYGB) is also known as bariatric surgery, this is done as a laparoscopic surgery with a minimal abdominal incision. An egg-sized pouch is created in the upper stomach then it is connected to the small intestine, known as the Roux limb. This creates a "Y" shaped connection and the intake of food then bypasses the rest of the stomach and the upper part of the small intestine. The absorption of fat, calories, minerals, and vitamins is reduced by this method to help weight loss.

• Single Incision Bariatric Surgery

If one wants to avoid multiple incisions and wants a cosmetic outcome, there is an option called Single Incision Laparoscopic Sleeve gastrectomy. Here the surgeon makes only 2-2.5 cm incision within the umbilicus and completes the entire surgery through this incision using specialized instruments, which is done in very few centers apart from Aster Medcity. This option is ideal for young individuals coming up for weight loss surgery.

Ask your surgeon about this for more information.