Obesity and Weight Loss Surgery

Obesity has reached epidemic proportions globally, with more than 1.7 billion people falling in the overweight/obese category (as per WHO). Weight loss can range from being relatively simple to being almost unattainable, depending on several factors such as type and severity of obesity, the age and lifestyle of the individual and the psychological mindset.

It is often seen that in the few spurts of knowledge dispersed on weight loss, people across resort to dieting, exercising and a host of other methods, though not always intelligently. Some in spite of balancing these are unable to shed and/or maintain their weight. These treatment options may prove to be beneficial for overweight people, however, incase of morbid obesity, which is estimated to afflict 20% of the obese population, there exists a 98% recidivism rate with such weight loss methods.

What is Obesity?

Obesity is excess of body fat that frequently results in significantimpairment of health. Obesity results when the size or numberof fat cells in a person's body increases. A normal-sized person has between 30 and 35 billion fat cells. When a person gains weight, these fat cells first increase in size and later in number.

Obesity generally is determined by calculating body mass index (BMI), which measures weight for height and is stated in numbers. BMI is calculated by the weight in kilograms divided by height in meters squared.

Your BMI may also be calculated by entering your personal information into the following equation:

BMI = [Weight (Kg) ÷ height (meter)²]

The obesity categories adopted in 1998 by the National Institutes of Health (NIH) are 2:

There are numerous causes of obesity. Few of which are listed below:

• Lifestyle and eating habits

Modern lifestyle and eating fast food which is high in fat and low in fruits and vegetables, long sitting at desk, lack of physical activity, watching of TV and sitting before computer for hours and suburban neighborhoods that require cars all magnify efficient fat storage

• Energy Balance

Weight is gained when one consumes more calories than the body requires for its normal functioning. The unused calories are stored as fat. One becomes obese if consistently consumes excess calories over a long period of time.

• Genetic Factors

In many cases underlying cause of morbid obesity is genetic i.e. One inherits the tendency to gain weight. Genes play an important role in tendency to gain excess weight. Just as some genes determine eye color or height, others affect our appetite, our ability to feel full or satisfied, our metabolism, our fat-storing ability, and even our natural activity levels.

Severe obesity damages the body by its mechanical, metabolic and physiological adverse effects on normal bodily function. These "co-morbidities" affect nearly every organ in the body in some way, and produce serious secondary illnesses, which may also be life-threatening. The cumulative effect of these co-morbidities can interfere with a normal and productive life and can seriously shorten life, as well. The risk of developing these medical problems is proportional to the degree of obesity.

Being seriously overweight can compromise your health and shorten your life. Overweight people-particularly those who were overweight during their young adult years-die earlier than people of average weight. Obesity causes heart disease, stroke, some types of cancer, type II diabetes , and arteriosclerosis (buildup of fatty deposits inside arteries). Obesity also increases risk of many other health problems, including gallstones, arthritis , and back pain .

Diabetes - More than three out of four persons with type II diabetes are at least 15 percent over their ideal weight . Excess weight contributes to the development of diabetes by making cells more resistant to the effects of insulin.

Insulin is a hormone that acts like a messenger in the body, telling muscle cells and fat cells that calories are on the way and preparing them to absorb the calories. In an obese person, the fat cells are already packed with sugar (in the form of glucose) and fat and, therefore, do not respond to insulin's signal. As a result, sugar and fat remain in the bloodstream.

The pancreas-the organ that secretes insulin into the bloodstream-reacts by increasing the amount of insulin it produces to overcome the cells' resistance. In people with diabetes, the pancreas cannot produce enough insulin to over come this resistance and the level of sugar continues to rise in their blood. 

The risk increases with age, being overweight, or having a family history of the disease. If you have any of these risk factors, ask your doctor if you should be tested for diabetes. For many people who are at risk of type II diabetes, exercising and regularly losing weight can prevent the onset of symptoms.

High blood pressure , or hypertension, is a major risk factor for heart disease and stroke. Blood pressure tends to increase with weight gain and with age.

It is not clear why obesity is a major cause of high blood pressure. It may be because blood needs to be under greater pressure to circulate through a larger body. Or it may be that a high level of insulin in the blood which is common in people who are obese causes a rise in blood pressure. If you have high blood pressure, losing weight may help you lower it. A weight loss of as little as 7 pounds can reduce blood pressure to a safe level in overweight people who have moderately high blood pressure.

Heart Disease  - More than one third of cases of heart disease are linked to being overweight. The more overweight a person is, higher the risk of developing heart disease. Excess weight is linked to heart disease mainly because it raises blood pressure and cholesterol level and can lead to type II diabetes. High blood pressure, high cholesterol level, and diabetes are major risk factors for heart disease.

The way in which fat is distributed on your body also affects your risk. People who accumulate fat around their waist are at greater risk of heart disease than who accumulate fat on their hips and thighs. 

What are the other medical hazards of Obesity?

Various other hazards of Obesity as cited by experts are:

• Sleep Apnea Syndrome - the stoppage of breathing during sleep is commonly caused in the obese, by compression of the neck, closing the air passage to the lungs.


• Respiratory Insufficiency


• Heartburn - Reflux Disease and Reflux Nocturnal Aspiration


• Asthma and Bronchitis


• Gallbladder disease- Gallbladder disease occurs several times as frequently in the obese, in part due to repeated efforts at dieting, which predispose to this problem.


• Stress urinary incontinence.


• Degenerative Disease of Lumbo-Sacral spine (Backbone).


• Degenerative Arthritis of weight-bearing joints like knee, hip.


• Venous stasis disease in the lower extremities.


• Emotional / Psychological Illness-Seriously overweight persons face constant challenges to their emotions: repeated failure with dieting, disapproval from family and friends and remarks from strangers. They often experience discrimination at work.
  
  
• Stereotypes of obese people – such as that they are lazy – may result in lower self esteem and poor body image. There is no wonder that anxiety and depression might accompany years of suffering from the effects of a genetic condition -- one which skinny people all believe should be controlled easily by will power.


• Social Effects- Severely obese persons suffer inability to qualify for many types of employment and tend to have higher rates of unemployment. There is a general societal belief that obesity is a consequence of a lack of self-discipline, or moral weakness.

What are the treatment options for Obesity?

Non-Surgical Treatments

The most common weight-loss approach is to eat less, eat sensibly, and exercise more . However, studies have shown that patients on diets, exercise programs, or weight-loss medication lose approximately 10 percent of their body weight but tend to regain two-thirds of it within one year, and almost all of it within five years.

The cycle of losing weight and gaining it back is called the “yo-yo effect.” While temporary weight loss can help, the yo-yo effect can also make it harder to lose weight in the future.

The National Institutes of Health report that 90 percent of the people who participate in diets and weight-reduction programs do not experience significant and sustained weight loss . For seriously overweight individuals, weight-loss surgery should be strongly considered when other therapies have failed, as a way to lose weight, improve their health and increase their quality of life.

Weight-Loss Surgery

If non-surgical methods have not helped you lose weight long-term , you still have another option. Studies demonstrate that weight-loss surgery, as compared to non-surgical treatments, yields the longest period of sustained weight loss in patients who have failed other therapies.Top

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