Morbid Obesity

Obesity

What is morbid obesity?

::	Morbid Obesity is a disease, which is chronic and lifelong
::	The disease is of excessive fat storage

What is BMI?

BMI or Body Mass Index is a measure of calculating a person's excess weight.

It is calculated by the following formula:

The BMI of a person who is:

Average built is
Overweight is
Obese is
Morbidly obese is

21 - 24.9
25 - 29.9
30 - 39.9
> 40

How does obesity differ from being overweight?

::	A person may appear fat, but may not be clinically obese. An overweight person has a BMI of 25-30. An obese person is one whose BMI exceeds 30.
::	The body mechanisms of obese persons controlling their weight are biologically set in such a manner that the patients gain weight easily
::	Even small amounts of weight loss are difficult to achieve and very difficult to sustain in patients of clinical obesity

What are the risks associated with morbid obesity?

::	Morbid Obesity is an extreme health hazard with medical, psychological, social, physical and economic comorbidities
::	There is increased risk of developing high blood pressure, diabetes (type 2), heart disease, stroke, gallstone disease and cancer of breast, prostate and colon. In fact there are 30 medical conditions which are directly related to obesity
::	Morbidly Obese persons are victims of prejudice and public ridicule due to their size. This repeated mental trauma results in psychological illness such as depression
::	Discrimination at work and employment results in poor socioeconomic conditions
::	Morbid Obesity is a significant cause of preventable early deaths

Why should morbid obesity be treated?

::	Morbid Obesity is a disease like any other disease
::	It has become necessary to recognize this entity as a cause of severe mental and physical morbidities which show significant improvement following weight loss
::	It is even more important for the patients themselves to understand this disease, its morbid implications and their inability to control it on their own

What is bariatric surgery?

::	Bariatric surgery is a treatment option for some patients with morbid obesity
::	This surgery helps you loose weight by altering your body's food digestion and absorption
::	There are several surgical options, each having their benefits and risks (Fig.)
::	The choice of procedure should be decided after a thorough discussion with your surgeon
::	Bariatric surgery is now being performed laparoscopically which is highly beneficial for these patients as it minimizes trauma of surgical access

Is morbid obesity surgery for you?

You will qualify for morbid obesity surgery if :

-	you have morbid obesity BMI more than 40 kg/m2
-	your BMI is 35-39.9 with severe obesity related medical conditions e.g. diabeties, arthritis, heart disease, high blood pressure.
-	other methods of weight loss (dietary / drugs) have been unsuccessful
-	you are unable to perform routine activities of daily living due to severe obesity
-	you have understood the surgical procedure for weight loss and the risks and after effects involved and are committed to making lifelong behavioral changes related to dietary and physical activities

Care for the morbidly obese requires a

-	comprehensive set-up. The management team comprises the surgeon, dietician, endocrinologist, physician, physiotherapist, psychiatrist.

How does obesity surgery change your life?

Lifestyle adjustments

-	Patient must learn to eat food in small amounts and to chew it well and slowly.

Follow-up is necessary every month for three months and then as advised by surgeon for dietary / nutritional counseling

Weight loss starts soon after surgery and continues for 2 years.

Improvements occurs in obesity related medical condition, with almost 60% patients not requiring medication

There is enhanced quality of life, with improved stamina, mood, self esteem and body image

Obesity surgery is not a cosmetic surgery, in fact plastic surgery may be required following weight loss after obesity surgery

"YOU WILL NEVER KNOW WHAT CAN BE DONE
UNTIL YOU TRY TO DO IT"