Wed, 29 May 2019
Dr Manish Madnani consultant gastrointestinal and hepatobiliary, pancreatic surgeon writes on an issue that is fast reaching epidemic proportions.
Obesity is excessive body weight when compared to the ideal for your height. It is calculated by your Body Mass Index (BMI= ratio of your body weight in kilograms and square of your height in metres). A person is said to be obese when their BMI is more than 30kg/m2. Ideal BMI should be within 18 to 25.
Gulf countries have some of the highest numbers of people living with obesity. Nearly one-third of the population is obese, and three quarters are overweight (BMI more than 25). Mostly this is the result of an imbalance between calorie consumption and utilisation. A healthy adult taking 500 kcal/day more than needed, will put on 1kg per week.
One meal at a fast-food outlet can contain 1,300 to 1,600 kilocalories; to burn that amount, one needs to walk approximately 42km! A marathon for one fast-food meal? You may be surprised by this calculation since it means everyone should be putting on tons of weight, but the reason they don’t is their metabolism, body’s absorption and daily physical activity.
Obesity is multifactorial as it covers other medical factors such as genetic make-up, dietary habits, hormonal problems, psychological factors, stress and so much more. The most common cause is the imbalance of calories.
The dangers posed by obesity are many, including heart-related issues, blood pressure, diabetes mellitus, sleep disturbances, joint pain, back pain, fertility problems, psychological issues and others.
The key to maintaining a healthy weight is early detection and action. Dietary modifications with physical activity can help a lot when applied early. Unfortunately, with established cases of obesity, these changes are required along with other means as compliance to strict lifestyle changes is challenging.
There are not many medicines available and those that were used in the recent past have been banned by most governments due to their serious side effects. It is not uncommon to hear news of someone dying due to the side effects of over the counter medicines!
In cases where there are no positive results after hard work and trials or when complications are arising or when a person's BMI is above 40, the ideal option may be either endoscopic or surgical intervention. Laparoscopic bariatric and metabolic surgeries are common nowadays with an increase in their safety and success rates.
Global data shows that 70 to 80 per cent of patients with hypertension will be free of all antihypertensive medicine after bariatric surgery
Around 90 per cent of patients with type 2 Diabetes will show improvement, and almost 75 per cent will be free of all anti-diabetes medication after bariatric surgery. And 80 per cent of patients will attain a healthy cholesterol level.
One can lose from 50 to 85 per cent of excess body weight after bariatric surgery. Other advantages include improvement in many issues such as sleep apnea, back and joint pain, fertility, PCOS, cardiovascular problems, acid reflux, and more.
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