Obesity
OBESITY TREATMENT:Geoherbal organises a ‘Cure Obesity’ campaign. We aim to help those who are suffering with significant weight issues and are searching for permanent solutions. Obesity cure is a lifelong process. Under this an individual is required to change the lifestyle. Obesity is defined by the National Institute of Health, USA, as a chronic disease.
What is obesity?
It refers to excess body fat. Standard body fat should be 25-30% in women and 18-23% in men. Men and women with greater proportion of body fats are considered to be obese. This disease occurs when the intake of calories is more than the regular calorie requirements.
Obesity is determined through calculating body mass index (BMI). BMI measures weight, in kilograms for height, in meters squared. The result is given in numbers.
The measurements are:
BMI Status
Below 18.5 Underweight
18.5 – 24.9 Normal
25 – 29.9 Overweight
30 – 34.9 Obese
35 – 39.9 Severe Obesity
> 40 Morbid Obesity
> 50 Super Morbid Obesity
The risks
Anyone anywhere can be affected by obesity. It is a common belief that some groups are more prone to obesity. Risk factors are:
Once a person becomes obese, there are more chances of developing dangerous and chronic diseases. They may also cause premature death. Some of the chronic diseases from obesity are:
Division of the waist circumference by the hip circumference gives the calculation. If the waist to hip ratio in women and men is greater or equal to 1, then they are known to be in high risk for developing acute health problem.
The popular ways for weight reduction are:
Gastric bypass surgery
This surgery makes the stomach smaller. It also makes the food to pass through part of the small intestine. You will feel more full than usual in this case. Hence it lowers the amount of food taken and the calories consumed. Thus it causes weight loss.
The common type of gastric bypass operation is Roux-en-Y gastric bypass. In this the stomach is smaller than the usual size. This is done at the top of the stomach by making a small pouch with the help of plastic band or surgical staples. The mid portion of the small intestine (jejunum) is connected to the smaller stomach directly. It thus bypasses the remaining part of the stomach as well as the top portion of the small intestine (duodenum). This process is executed by creating a big incision in the abdomen. This can also be done by creating a smaller incision with the help of micro instruments as well as a guiding camera throughout the surgery (laparoscopic approach).
In the normal digestion, on the other hand, the food you eat passes through the stomach before entering the small intestine. It is here that the maximum of the calories and the nutrients are absorbed. After this it passes into the large intestine (colon), while the rest of the waste is excreted.
What should you expect after the surgery?
The surgery usually includes around 4-6 days of hospital stay. Many of the patients can retrieve back to their daily chores within 3-5 weeks.
This kind of surgery usually cause dumping syndrome. It happens when the food moves very fast through the intestines and the stomach. This leads to weakness, nausea, faintness, sweating and also diarrhea immediately after meals. Such symptoms are worsened by high calorie and high refined foods. In few cases the patient becomes very weak that he needs to lie down unless the symptom cease.
Why is it done?
This kind of surgery is usually considered when the BMI exceeds 40 or the patient have weight related disabling condition or a life threatening problem. The doctor may consider the gastric bypass surgery if the patient has not been able to reduce weight with alternative treatments.
The below mentioned conditioned can also be considered or required:
All the above surgeries are risky and thus it is very crucial for you to consult your treatment possibilities with the panel of experts before deciding the best one for yourself.
How good is it?
Many people who have undergone this surgery began to lose weight and the process continued for 12 months. Some of the weight loss can be regained. The other approach of surgery also showed similar kind of result. 69-82% of extra-weight had been lost in between 12-54 months.
Gastric binding
The adjustable gastric band system has been developed to help in long term weight loss. This has been acquired by many renowned laparoscopic surgeons across the world to overcome the weight loss problem. This process works by decreasing the stomach capacity.
The adjustable Gastric band system-
This is a plain silicone ring having an inflatable balloon tucked inside. This is connected to an injection port through a thin, long, kink resistive silicone tube. The band is fastened round the upper stomach, which is 15mm under the gastro-oesophageal junction. Through this the stomach is divided into a lower stomach and a 15ml little upper pouch. The injection port is placed under the skin which is accessible for the injection needle. When the fluid is injected through the access port, it inflates the balloon while the end opening of the upper pouch gets narrower. The band hence restricts the amount of food eaten while slowing down the vacating process from the pouch. The opening is adjustable by withdrawal or injection of fluid. These functions are conducted during the outpatient visits, guided by exercise regimen, food toleration, and pace of weight reduction. Hence, the band is fine tuned according to the necessities of the patient. Satisfaction and fullness can be experienced even with a little amount of food leading to dramatic weight reduction.
Laparoscopic surgery (keyhole surgery):
In this a big incision is not necessary. Access to stomach area is made through 4-6 small incisions, which are then sealed with dissolving structures. Hospital stay is for one night. Recovery pace is rapid. Lot of people gets back to their work in a week. The surgery is conducted under general anaesthesia that can stay up to an hour. This surgery is the least traumatic one as it does not includes stapling, re-routing or cutting.
Laparoscopic sleeve gastrectomy:
It is an effective and safe weight reducing surgical procedure targeted for high risk patients and those who want to avoid the risk of weight reduction surgery.
This surgery process (also known as greater curvature gastrectomy, vertical gastrectomy, vertical gastroplasty, gastric reduction and parietal gastrectomy) is an emerging one which is becoming increasingly popular across the world. It leads to weight reduction by limiting the food eaten without any malabsorption or bypass of intestines.
What it is and how it works:
This is a weight reduction procedure working through gastric restriction (decreased stomach volume). Under this, a narrow tube is fashioned to divide the stomach vertically. The tube is almost the same diameter as of duodenum and esophagus. The portion of the stomach through the medial curvature that is in continuation with the food pipe is kept back as the tube while the portion external to the tube, of greater curvature is removed. Thus 85% of the stomach is totally removed.
The removed stomach portion elongates while eating food. It stores the food and performs reservoir function. The stomach portion that is retained has the shape of the banana. The storing capacity is drastically reduced. The stomach will feel full with small amount of food. This does not involve any intestinal bypass. Roux-en-Y gastric bypass procedure divides the stomach instead of removing where the pylorus is not included.
This process was performed laparoscopically initially in high obesity patient in order to reduce the risk of weight reduction surgery. Duodenal switch is also efficient for obese patients, but it includes several risk factors. First stage laparoscopic sleeve gastrectomy is the reasonable remedies for this problem. The stomach reduction reduces the BMI. After that they are operated with the second stage. The second stage can be Roux-en-Y or duodenal switch or Lap Band.
It was soon realized that the surgery leaves the patients with significant weight loss and also maintains the weight longer than expected. Thus the second stage may not be required. This led to the introduction of laparoscopic sleeve gastrectomy as the single weight loss procedure. It was conceived originally by Dr. Johnston from England. It is an improvement over the many gastroplasty procedures. Such operations are hardly followed due to the staple placement, mesh and silastic rings round the stomach pocket.
Benefits of sleeve of sleeve gastrectomy weight reduction surgery:
This process, in comparison to the Lap Band One is only a onetime process. It excludes any adjustments and the probable complications of a foreign body part. It avoids the risk of erosion, slippage and infection.
Laparoscopic sleeve gastrectomy for low BMI patients:
The procedure started in England as the sole weight reduction process for people with BMI more than 35kg/M2. It is known to be safe and effective even at 5 years of age. The individuals with low BMI who should consider this process are:
Demerits of vertical gastrectomy weight reduction surgery:
The laparoscopic surgery is comparably a new procedure being used for weight loss for the last 4 years where as the gastric bypass and the Lap Band procedure has been prevalent for over ten years. There is a chance of insufficient weight loss and weight regain due to pouch enlargement. This is more probable in the procedures excluding intestinal bypass. This risk and fear may not be true in sleeve gastrectomy because the stomach pouch is based on the muscular and thick curvature that is comparatively non distensible. For the high BMI patients the two stages of sleeve gastrectomy are more effective and safe compared to one operation. After this surgery soft calories like milk shakes, ice-cream can be taken unlike gastric bypass. The latter causes dumping and are avoided because of their unwanted symptoms, and also because of the removal of the stomach.
The complications and the risks:
The laparoscopic sleeve gastrectomy excludes stomach stapling, leaks as well as other stapling related complications. The other surgery procedure includes:
Like all other weight reducing surgical procedure sleeve gastrectomy requires a stringent post operative diet. The patients needs to adhere to a fluid based diet at least for 2 weeks post surgery. 4-6 weeks after the surgery the patient can take 600-800 calorie of solid diet per day. After 2 years of surgery many of the patients can take 1000-1200 calories each day.
Long term result of weight reduction:
The patients undergoing vertical gastrectomy operation feels a loss of 60-80% of body weight. Rapid and huge weight loss along with very less complications reflects the sleeve gastrectomy surgical procedure a smart choice as a weight reducing process.
What is obesity?
It refers to excess body fat. Standard body fat should be 25-30% in women and 18-23% in men. Men and women with greater proportion of body fats are considered to be obese. This disease occurs when the intake of calories is more than the regular calorie requirements.
Obesity is determined through calculating body mass index (BMI). BMI measures weight, in kilograms for height, in meters squared. The result is given in numbers.
The measurements are:
BMI Status
Below 18.5 Underweight
18.5 – 24.9 Normal
25 – 29.9 Overweight
30 – 34.9 Obese
35 – 39.9 Severe Obesity
> 40 Morbid Obesity
> 50 Super Morbid Obesity
The risks
Anyone anywhere can be affected by obesity. It is a common belief that some groups are more prone to obesity. Risk factors are:
- Genetic problem of obesity
- Being overweight as a child
- Absence of physical activity
- Excessive consumption of fat food and low intake of vegetables and fruits
Once a person becomes obese, there are more chances of developing dangerous and chronic diseases. They may also cause premature death. Some of the chronic diseases from obesity are:
- High blood cholesterol
- Type 2 diabetes mellitus
- Sleep apnea
- Osteoporosis
- Liver disease
- Hypertension, heart attack, stroke, heart failure
- Gout
- Gallbladder disease
- Breast cancer, uterus cancer, ovaries and cervix
- Menstrual irregularities
- Infertility in women
Division of the waist circumference by the hip circumference gives the calculation. If the waist to hip ratio in women and men is greater or equal to 1, then they are known to be in high risk for developing acute health problem.
The popular ways for weight reduction are:
- Gastric Binding
- Gastric Bypass
- Laparoscopic sleeve
- Gastrectom
Gastric bypass surgery
This surgery makes the stomach smaller. It also makes the food to pass through part of the small intestine. You will feel more full than usual in this case. Hence it lowers the amount of food taken and the calories consumed. Thus it causes weight loss.
The common type of gastric bypass operation is Roux-en-Y gastric bypass. In this the stomach is smaller than the usual size. This is done at the top of the stomach by making a small pouch with the help of plastic band or surgical staples. The mid portion of the small intestine (jejunum) is connected to the smaller stomach directly. It thus bypasses the remaining part of the stomach as well as the top portion of the small intestine (duodenum). This process is executed by creating a big incision in the abdomen. This can also be done by creating a smaller incision with the help of micro instruments as well as a guiding camera throughout the surgery (laparoscopic approach).
In the normal digestion, on the other hand, the food you eat passes through the stomach before entering the small intestine. It is here that the maximum of the calories and the nutrients are absorbed. After this it passes into the large intestine (colon), while the rest of the waste is excreted.
What should you expect after the surgery?
The surgery usually includes around 4-6 days of hospital stay. Many of the patients can retrieve back to their daily chores within 3-5 weeks.
This kind of surgery usually cause dumping syndrome. It happens when the food moves very fast through the intestines and the stomach. This leads to weakness, nausea, faintness, sweating and also diarrhea immediately after meals. Such symptoms are worsened by high calorie and high refined foods. In few cases the patient becomes very weak that he needs to lie down unless the symptom cease.
Why is it done?
This kind of surgery is usually considered when the BMI exceeds 40 or the patient have weight related disabling condition or a life threatening problem. The doctor may consider the gastric bypass surgery if the patient has not been able to reduce weight with alternative treatments.
The below mentioned conditioned can also be considered or required:
- The patient does not have a history record of alcohol abuse.
- The patient has been suffering from obesity for a minimum of 5 years.
- The patient is between 18-65 years of age.
- The patient does not have any kind of psychiatric disorder or untreated depression.
All the above surgeries are risky and thus it is very crucial for you to consult your treatment possibilities with the panel of experts before deciding the best one for yourself.
How good is it?
Many people who have undergone this surgery began to lose weight and the process continued for 12 months. Some of the weight loss can be regained. The other approach of surgery also showed similar kind of result. 69-82% of extra-weight had been lost in between 12-54 months.
Gastric binding
The adjustable gastric band system has been developed to help in long term weight loss. This has been acquired by many renowned laparoscopic surgeons across the world to overcome the weight loss problem. This process works by decreasing the stomach capacity.
The adjustable Gastric band system-
This is a plain silicone ring having an inflatable balloon tucked inside. This is connected to an injection port through a thin, long, kink resistive silicone tube. The band is fastened round the upper stomach, which is 15mm under the gastro-oesophageal junction. Through this the stomach is divided into a lower stomach and a 15ml little upper pouch. The injection port is placed under the skin which is accessible for the injection needle. When the fluid is injected through the access port, it inflates the balloon while the end opening of the upper pouch gets narrower. The band hence restricts the amount of food eaten while slowing down the vacating process from the pouch. The opening is adjustable by withdrawal or injection of fluid. These functions are conducted during the outpatient visits, guided by exercise regimen, food toleration, and pace of weight reduction. Hence, the band is fine tuned according to the necessities of the patient. Satisfaction and fullness can be experienced even with a little amount of food leading to dramatic weight reduction.
Laparoscopic surgery (keyhole surgery):
In this a big incision is not necessary. Access to stomach area is made through 4-6 small incisions, which are then sealed with dissolving structures. Hospital stay is for one night. Recovery pace is rapid. Lot of people gets back to their work in a week. The surgery is conducted under general anaesthesia that can stay up to an hour. This surgery is the least traumatic one as it does not includes stapling, re-routing or cutting.
Laparoscopic sleeve gastrectomy:
It is an effective and safe weight reducing surgical procedure targeted for high risk patients and those who want to avoid the risk of weight reduction surgery.
This surgery process (also known as greater curvature gastrectomy, vertical gastrectomy, vertical gastroplasty, gastric reduction and parietal gastrectomy) is an emerging one which is becoming increasingly popular across the world. It leads to weight reduction by limiting the food eaten without any malabsorption or bypass of intestines.
What it is and how it works:
This is a weight reduction procedure working through gastric restriction (decreased stomach volume). Under this, a narrow tube is fashioned to divide the stomach vertically. The tube is almost the same diameter as of duodenum and esophagus. The portion of the stomach through the medial curvature that is in continuation with the food pipe is kept back as the tube while the portion external to the tube, of greater curvature is removed. Thus 85% of the stomach is totally removed.
The removed stomach portion elongates while eating food. It stores the food and performs reservoir function. The stomach portion that is retained has the shape of the banana. The storing capacity is drastically reduced. The stomach will feel full with small amount of food. This does not involve any intestinal bypass. Roux-en-Y gastric bypass procedure divides the stomach instead of removing where the pylorus is not included.
This process was performed laparoscopically initially in high obesity patient in order to reduce the risk of weight reduction surgery. Duodenal switch is also efficient for obese patients, but it includes several risk factors. First stage laparoscopic sleeve gastrectomy is the reasonable remedies for this problem. The stomach reduction reduces the BMI. After that they are operated with the second stage. The second stage can be Roux-en-Y or duodenal switch or Lap Band.
It was soon realized that the surgery leaves the patients with significant weight loss and also maintains the weight longer than expected. Thus the second stage may not be required. This led to the introduction of laparoscopic sleeve gastrectomy as the single weight loss procedure. It was conceived originally by Dr. Johnston from England. It is an improvement over the many gastroplasty procedures. Such operations are hardly followed due to the staple placement, mesh and silastic rings round the stomach pocket.
Benefits of sleeve of sleeve gastrectomy weight reduction surgery:
- The volume of the stomach is reduced, but it functions normally with small intake of food.
- The extra stomach capacity is removed. This eliminates maximum of the Ghrelin hormone production. It also lowers the huger sensation of these people.
- The absorption of vitamins and minerals is not hampered because there is no intestinal segment bypass procedure.
- It does not include food dumping in the intestine and also excludes symptoms that occur post gastric bypass. This is because the pylorus is kept intact post sleeve gastrectomy.
- The possibility of intestinal blockage, protein deficiency, osteoporosis, vitamin deficiency and anaemia are eliminated due to the avoidance of intestinal bypass.
- It reduces the possibility of ulcer.
- It is convertible to other weight reducing procedure.
This process, in comparison to the Lap Band One is only a onetime process. It excludes any adjustments and the probable complications of a foreign body part. It avoids the risk of erosion, slippage and infection.
Laparoscopic sleeve gastrectomy for low BMI patients:
The procedure started in England as the sole weight reduction process for people with BMI more than 35kg/M2. It is known to be safe and effective even at 5 years of age. The individuals with low BMI who should consider this process are:
- Those considering the Lap Band without being concerned about foreign body or if they are unsure whether they have access to the regular band filling which is compulsory for weight reduction after the procedure. Patients with low BMI can have slower weight loss, restriction and reduction in appetite post the lap band until 1-2 filling are made. Such patients feel better post sleeve gastrectomy. The weight loss and the restriction in the latter case starts immediately and is faster.
- People who are considering the long term probable side effects of intestinal bypass like vitamin and protein deficiency, ulcers, anaemia, intestinal blockage, osteoporosis etc.
- Those having other medical issues which restrict them from going for weight reduction surgery like anaemia, extensive prior surgery, crohn’s disease and other complicated medical situations.
- Patients who have to consume anti-inflammatory medicines can consider this surgery. Such medications are usually avoided after the gastric bypass due to the risk of ulcer.
Demerits of vertical gastrectomy weight reduction surgery:
The laparoscopic surgery is comparably a new procedure being used for weight loss for the last 4 years where as the gastric bypass and the Lap Band procedure has been prevalent for over ten years. There is a chance of insufficient weight loss and weight regain due to pouch enlargement. This is more probable in the procedures excluding intestinal bypass. This risk and fear may not be true in sleeve gastrectomy because the stomach pouch is based on the muscular and thick curvature that is comparatively non distensible. For the high BMI patients the two stages of sleeve gastrectomy are more effective and safe compared to one operation. After this surgery soft calories like milk shakes, ice-cream can be taken unlike gastric bypass. The latter causes dumping and are avoided because of their unwanted symptoms, and also because of the removal of the stomach.
The complications and the risks:
The laparoscopic sleeve gastrectomy excludes stomach stapling, leaks as well as other stapling related complications. The other surgery procedure includes:
- 0.5% of non fatal pulmonary embolus
- 0.5% of Splemectomy
- 0.5% of deep vein thrombophlebitis
- 0.2% of pneumonia
- Small bowel blockage
- 0.25% of severe respiratory distress syndrome
- 0.5% of post operative bleeding
Like all other weight reducing surgical procedure sleeve gastrectomy requires a stringent post operative diet. The patients needs to adhere to a fluid based diet at least for 2 weeks post surgery. 4-6 weeks after the surgery the patient can take 600-800 calorie of solid diet per day. After 2 years of surgery many of the patients can take 1000-1200 calories each day.
Long term result of weight reduction:
The patients undergoing vertical gastrectomy operation feels a loss of 60-80% of body weight. Rapid and huge weight loss along with very less complications reflects the sleeve gastrectomy surgical procedure a smart choice as a weight reducing process.
