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Obesity is a global health problem. In India the obesity is rising among the general population. The obesity is linked to various other health disorders such as diabetes, high blood pressure, fatty liver, heart disease, sleep apnea, stroke, bone and joint disorders and gastroesophageal reflux disease. It also increases the risk of cancer. Severe obesity also interferes with the routine work and socialization.
Most patients with severe obesity cannot lose and maintain weight with nonsurgical treatment. Studies have shown that surgery offers the only permanent and sustained weight loss after five years in comparison to other options.The operations to lose weight are called bariatric surgery. This operation make changes in the digestive tract and limits the amount of food which can be eaten and/or reduces the absorption of nutrients. The commonly done operations in India include sleeve gastrectomy, Roux-en-Y gastric bypass and mini gastric bypass. These surgeries are done when diet and exercise have failed to reduce the weight to an optimum level.
Body Mass Index (BMI) is a calculation to know the weight in relation to the height. It is the most commonly used formula to determine the grade of obesity.
Candidates for weight loss surgery (Asians):
The BMI is 37.5 or higher
The BMI is 32.5 or higher with weight-related health conditions
Inability to lose or maintain weight loss using dietary or medical measures
These operations helps reduce weight and reduces risk of associated diseases. But not all excess weight will be lost; only 50-75% of excess weight loss is expected. More than 90 percent of individuals are successful in maintaining 50 percent or more of their excess weight loss following surgery. Several large studies have shown that risk of death is reduced following surgery. The surgery improves and resolves most of the obesity related diseases in majority of the individuals. For example diabetes improved in more than 85 percent and resolves in 78 percent. In addition to improvement in health and longevity overall quality of life is improved.
There is a need for regular lifelong follow-up after the surgery. Strict compliance with the dietary, exercise and lifestyle modifications is required before and after the surgery.
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