There are many of problems that obese individuals face in their daily lives. Finding a pair of jeans to taking a seat on an airplane, it’s a big challenge. But, what most of us seem to miss, are the health hazards that pose an even greater risk. Obesity becomes morbid obesity when an adult is 45kg or more over ideal body weight, has a BMI of 32.5 kg/m2 or more in combination with a health-related condition such as diabetes, hypertension, obstructive sleep anpoea or high cholesterol.
At Fortis Hospitals, we have made it our prerogative to educate individuals about the hidden dangers of being obese and the best way to overcome the life-threatening situation it may put them in.
body weight is also associated with cancer and early death. Most non-surgical weight-loss programs are based on a combination of diet, behavior modification, and regular exercise. However, published scientific papers report that these methods do not help resolve morbid obesity because they fail to help people maintain weight-loss. In fact, more than 95% of people regain the weight they lose within a few years after nonsurgical weight-loss methods.
Over the last decade, Bariatric Surgery (Weight-loss surgery) has been continually refined to improve results and minimise risks. Today, different clinical data findings validate the use of Bariatric Surgery as a safe and effective weight-loss treatment in the long-run when other methods have failed.
Fortis Obesity and Diabetes Surgery Centre at Bannerghatta Road and Cunningham Road, Bangalore offer special focus on evaluation, development and expansion of procedures and techniques in Bariatric Surgery. Our state-of-theart centres are fully equipped with the best possible combination of people, process and technology to the level similar to a centre for healthcare excellence.
The centre offers a wide range of services, both medical management and surgical interventions, to any patient who is at the risk of health problems associated with obesity. More importantly it offers a holistic approach to obesity care with special attention that involves multidisciplinary integration of different specialties namely Endocrinology, Internal Medicine, Cardiology, Orthopedic, Reproductive Medicine, Pulmonology, Nutritionist, Physiotherapy, Anaesthesia, Counselors, etc. The centre also conducts regular obesity support group meetings, where people suffering from obesity are able to interact and gain knowledge from experts and share their experiences with other fellow patients.
The comprehensive Bariatric Surgery programme at Fortis Hospitals helps obese patients to lose weight through either restrictive procedures or malabsorptive procedures or a combination of both.
Over the last decade, Bariatric Surgery (Weight-loss surgery) has been continually refined to improve results and minimise risks. Today, various clinical data findings validate the use of Bariatric Surgery as a safe and effective weight-loss treatment in the long run when other methods have failed.
Compared to other weight-loss methods, such as dieting, liposuction, physical led activity, surgery provides the longest period of sustained weight-loss in patients for whom all other therapies have failed. It has also been shown to improve many obesity related health conditions, such as Type 2 Diabetes,Sleep Apnoea and High Blood Pressure. Many patients who have had Bariatric Surgery report improvements in their quality of life, social interactions, psychological wellbeing, employment opportuunities and economic condition.
As you consider weight-loss treatment with Bariatric Surgery, it’s important to assess your options using these critical factors-safety, effectiveness, and support.
Safety: The safety of a procedure can be indicated by complication rates, mortality rates, or the need for secondary procedures to resolve problems
Effectiveness: The effectiveness of a weight-loss procedure can be measured in weight-loss at 1-year and weight-loss at 3 years or more. Most weight-loss procedures have 1- year results. However, longer-term results are a better indicator of effectiveness. Improvements in obesity-related health conditions after surgery, such as type 2 diabetes, High Cholesterol, High blood pressure, and Obstructive sleep apnoea, are also good indicators of effectiveness.
Support: Experts agree that ongoing support following any procedure is essential to help patients modify behavior, lose weight and keep the weight off. The surgeon and staff at the surgeon’s office play a vital role in providing support before and after surgery. The clinic may also offer support groups for patients and provide access to counselors, dieticians, and nutritionists. Talking with the surgeon’s staff and patients is a good way to find out how much support is offered by the bariatric clinic. It’s also important to speak with your friends and family about their willingness to provide encouragement and support.
Gastric bypass, which combines restrictive and malabsorptive surgery techniques, is the most frequently performed bariatric procedure across world. In this procedure, stapling creates a small stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the lower stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption and the duodenum. To achieve this, the small intestine is divided beyond the duodenum and a connection with the new, smaller stomach pouch is constructed. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.
By creating a smaller stomach pouch, a Gastric Bypass limits the amount of food that can be eaten at one time, so you feel full sooner and stay full longer. By bypassing a portion of the small intestine, it also causes your body to absorb fewer calories. As you eat less food, and absorb fewer calories, your body will stop storing excess calories and start using its fat supply for energy.
It is a restrictive procedure that limits the amount of food you can eat by reducing the size of your stomach. During this procedure a thin vertical sleeve of stomach is created using a stapling device. This sleeve is typically about the size of a banana. The excised portion of the stomach is removed.
As you eat less food, your body will stop storing excess calories and start using its fat supply for energy. Also reduced secretion of ghrelin (hinger hormone that stimulates hunger) due to the removed portion of stomach results in significant reduction in appetite.
Gastric Banding is a restrictive procedure because it limits the amount of food you can eat at one time. During this procedure, the gastric band is placed around the stomach, dividing it into two parts: a small upper pouch and a lower stomach.
By creating a smaller stomach pouch, the gastric band limits the amount of food that can be eaten at one time, so you feel full sooner and stay full longer. As you eat less food, your body will stop storing excess calories and start using its fat energy supply
Your weight, the physical symptoms you report, and other factors help your surgeon decide if a band adjustment is necessary. The timing and number of band adjustments are different for everyone and can only be determined by each patient's surgeon
Bariatric surgeons and their patients have a choice of procedures that use different techniques to achieve weight loss. All these techniques can be broadly classified into
The restrictive operations include adjustable gastric band, vertical-banded gastroplasty and sleeve gastrectomy. They act by restricting calorie intake. Bilio-Pancreatic Diversion (BPD) with or without duodenal switch (DS) operation is predominantly malabsorptive with a small restrictive component. Roux-N-Y Gastric Bypass (RYGBP) has mainly a restrictive component due to creation of a small gastric pouch as well as a varying degree of malabsorption. All these surgery options are predominantly performed laparoscopically.
Single Incision Laparoscopic Surgery (SILS) is the next evolutionary step in the Minimal Access Surgery (MAS) revolution allowing the operations to be performed through a single 25 mm incision rather than multiple incisions (4 – 5 incisions in case of conventional laparoscopic technique). In Bariatric Surgery, SILS approach offers a superior cosmetic result since the scar is almost invisible in a month time. Also since there is only one wound, post-operative wound pain and its related complications are lesser as compared to the conventional laparoscopic surgery technique. Currently, SILS is applicable to Gastric Banding and Sleeve Gastrectomy. One should keep in mind that choosing between SILS and the conventional laparoscopic surgery depends on patients’ conditions and their surgeon’s judgement
Bariatric Surgery is an effective weight-loss treatment but you have to do your part too. Understanding and actively engaging in a lifestyle that supports achieving and maintaining a healthier weight is vital for success. Staying connected with your bariatric team is just as important.
Work closely with our medical team of experts to understand what changes you will need to make in your daily routine to help ensure the success of your surgery. You should understand and agree with your postoperative dietary requirements, exercise needs and any other changes you will be making before you receive surgery. It is a good idea to implement these changes as well as any other behavior modifications preoperatively to help you transition more easily into your new postoperative lifestyle.
Adjusting to your new diet The modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight-loss. It is important to remember that every surgeon does not perform the same Bariatric Surgery procedure and that the dietary guidelines will be different for each surgeon and each type of procedure. What is most important is that you adhere strictly to your surgeon’s recommended guidelines.
Your ability to resume presurgery levels of activity will vary according to your physical condition, the nature of the activity, and the type of bariatric surgery you had. Many patients return to full presurgery levels of activity within 6 weeks of their procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a few weeks.
It is strongly advised that women of childbearing age use the most effective forms of birth control during the first 16 to 24 months after Bariatric Surgery. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirement.
Nutritional deficiencies that occur over the course of many years will need to be monitored. Over time, you will need periodic checks for anemia (low red blood cell count) and vitamin B12, folate and iron levels. Follow-up tests will initially be conducted every 3 to 6 months, or as needed, and then every 1 to 2 years. Follow-up care is recommended for life.
The widespread use of support groups has provided Bariatric Surgery patients with an excellent opportunity to discuss their various personal or other issues. Most learn, for example, that Bariatric Surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have had on their emotional well-being.
Exactly why, Fortis Hospitals has a support group in place to assist you with short-term and long-term questions and needs.Happy Losers has been created with the aim of providing a forum for those considering Bariatric Surgery and patients that have already undergone the process. The group will be the perfect platform for patients, doctors and family members to interact and share their views on the subject of weight-loss surgery. Moreover, the support group is also aimed at helping patients copy with the lifestyle changes post surgery
Our Bariatric Surgeons who frequently perform the surgery will tell you that ongoing postsurgical support helps produce the greatest level of success for their patients