Obesity, a malady of the twenty first century, is accumulation of fat in the body to the extend of endangering health.There has been an alarming increase in the number of obese people all over the world, especially in the developed countries. Many countries have initiated measures against obesity considering it
as a public health issue.
Obesity can be familial in 25%
30% of people. But the main villain is the change in life-style of the people.Excessive food intake and lack of physical exercise contributes to Obesity. The new fast-food culture speeded it up. Obesity
is thus the reward to those who gulp down food, in greater quantity than is needed.Certain diseases and mental ailments also can be associated with obesity.
There is a desired weight which is normal or proportional to the height of the body. Obesity is determined by noting the changes in this ratio, the Body Mass Index (BMI).
BMI (Body Mass Index) is the fraction found out by dividing the body weight in Kilogrammes by the square of the height in Meters.
|Normal Weight||18.0 – 23 kg/m|
|Obesity Grade I||23.0 – 30 kg/m|
|Obesity Grade II||30.0 – 40 kg/m|
|Obesity Grade III||40.0 – 50 kg/m|
|Obesity Grade IV||50.0 – 60 kg/m|
|Obesity Grade V||> 60 kg/m|
Diabetes mellitus, hyperlipidemia, increased incidence of various cancers, stroke,varicose veins and asthma are some diseases in the causation of which obesity
of BMI greater than 35 may play a role.Besides, the desire to stay away secluded from social assemblies could create mental stress and depression.
The first-line measures are,doubtless, to control the intake of food and orderly exercises. Still, the long term
effects of these conservative methods areat best only 2 -20%. Orlistat is a medicine widely used for obesity that could help reduce weight by 5-10 Kgms. But it is not safe for those with gastrointestinal or
Bariatric surgery is the only permanent remedy to reduce obesity and promises long-term alleviation and relief from obesity related diseases. It has been proved that obesity can be fully treated
with modern laparoscopic surgical techniques which are mainly three: Lap Banding, Lap Sleeve Gastrectomy and Gastric Bypass. Obese people almost always need extra food and consequently their stomach could also be larger in size.Their hunger will be satiated only if stomach is fully distended with food and
thus the pressure exerted by the stretched stomach wall sends the satiety signals to the brain. Of this intake,whatever exceeds the actual need of the body is directly converted to fat,accumulation of which in several parts of the body leads to diseases. Bariatric Surgeon can limit the amount of food that
the stomach can accommodate by reducing its size . Surgeon ,endocrinologist, physician,dietician, physiotherapist,physiatrist and the psychologist all team up for the necessary evaluation and treatment. Hospital stay need be only for a maximum of five days after which the person can follow his routine jobs
After the first or second day,liquid diet can be taken beginning with boiled and cooled water slowly changingover to fruit juices, but not more than half a cup at a time. Carbonated and high calorie drinks are better avoided. This stage will be for three weeks after surgery.
After getting adjusted so with stage 1 diet,skimmed milk, soya milk, mixie-ground gruel (kanji),oats etc. can be taken, from ½ to ¾ of a cup at a time.This stage will be for three to six weeks.
Solid diet can be allowed after six weeks. From now onwards, fat-free food can be taken at frequent intervals. 1. Make meals small in quantity. Excess food can cause pain, dizziness and vomiting and extra increments in calorie intake. The meal is to be stopped before the actual sensation of fullness. 2. Eat slowly. Drink water, also slowly. 3. Drink water at frequent intervals and avoid drinking in between meals. 4. Chew the food well; it will help in digestion. 5. Do not gulp down food, since solid mass of food could block the narrowed post-operative gastrointestinal passage and can cause severe abdominal pain. 6. It will take time for the GIT to adapt to absorbtion of nutrients since part of the stomach and small intestine has been bypassed. So, supplements of vitamins and minerals as advised by the doctor should, therefore, be taken. 7. Foods containing multivitamins and minerals, calcium, iron, Vitamin B-12 and Vitamin are the ones to be Supplemented
Protein-containing food is necessary to help healing of the surgical wound, strengthen muscles and to reduce fat. The day’s food should contain
60 Gms. of protein. The directions are:
Ø Start the day with protein food
Ø Use skimmed milk or soya milk
Ø Include protein powders
Ø Avoid sugar and fat-rich food.
Ø Reduce the intake of food to one cup.
1. Control or eliminate sugar and fatrich food.
2. Compulsorily avoid untimely food.
3. Do daily exercises at the appointed time.
4. Consult the doctor as scheduled and follow instructions.
5. Desist from liquor.