Obesity

Obesity is a disease characterised by excessive body fat. People who are medically obese usually are affected by behaviour, genetic and environmental factors that are difficult to control with dieting. Obesity increases the likelihood of certain diseases and other related health problems.

Referred from www.OSSI.com and www.OFI.com

BMI [As per Indian Standards]:

The international classification of adults in the categories of underweight, overweight and obese according to BMIs is as follows:

Grade BMI Class Risk of Disease
Underweight <18.50 - +
Healthy 18.50 - 24.99 - -
Overweight ≥25.00 - INCREASED
Moderate Obesity 30.00 - 34.99 I HIGH
Severe Obesity 35.00 - 39.99 II VERY HIGH
Morbid Obesity ≥40.00 III EXTREMELY HIGH

The numbers for Asian adults in the same categories are below:

Grade BMI Class Risk of Disease
Underweight <18.5 - +
Healthy 18.5 - 22.4 - -
Overweight 22.5 - 27.4 - INCREASED
Moderate Obesity 27.5 -32.4 I HIGH
Severe Obesity 32.5 - 37.4 II VERY HIGH
Morbid Obesity >37.5 III EXTREMELY HIGH

BMI chart referred from IFSO-APC consensus 2011

BMI = measured as kg/m2

Co-morbidities:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Gastroesophageal Reflux Disease (GERD)
  • Osteoarthritis
  • Sleep apnoea and respiratory problems

Treatment:

First Line Treatment:

Diet control -- Nutrition.

Physical activity -- Exercise

Lifestyle modifications including: Shift above Diet control and Physical activity points.

Second Line Management:

Pharmacotherapy

Gastric balloons

Third Line Management:

Surgical Treatment:

Weight-loss surgery has proven to be a successful method for the treatment of morbid obesity. Today, there are multiple options for patients and surgeons to choose from based on their convenience thanks to the evolution of surgical principles. Some of the surgical procedures performed to treat obesity include:

  • Gastric banding
  • Sleeve gastrectomy
  • Roux-en-Y gastric bypass
  • Mini gastric bypass
  • Other novel procedures
  • Cosmetic procedures such as liposuction and tummy tuck

The use of laparoscopy for performing these procedures is the biggest advancement in bariatric surgery. The laparoscopic procedure is a minimally invasive procedure where the surgery is performed through small incisions. Patients experience minimal discomfort and rapid recovery with the process.