If a body starts to accumulate to much of fat tissue, the BMI grows and a person becomes overweight which leads to obesity development. Obesity causes lie in an imbalance between the consumed and utilized energy levels. One of the main obesity symptoms is an excess body weight. Obesity treatment options include a wide range of methods and techniques, including food behaviour adjustment and surgery (sleeve gastrectomy or gastric bypass). Below you may find a lot more useful information about this condition and obesity treatment options.
Obesity is a disorder characterized by high amounts of body fat.
It occurs over a period of time when you consume more calories than you burn off. The balance between calories-in and calories-out is different for each person. The factors that might affect your weight include:
- Genetic makeup: The body’s natural ability to burn fat
- Eating high-fat foods
- Physically inactive
Although it affects many people on a cosmetic level, it can cause a lot of troubles within the body including:
- Heart disease
- High blood pressure
WHAT IS BMI (BODY MASS INDEX)?
The body mass index (BMI) is a statistical measurement derived from your height and weight. It is considered an effective way to estimate healthy body weight and measures not only the percentage of body fat, but also muscles distribution in the body to give you the idea of your “problem” areas. The calculation of BMI is derived by dividing the patient’s body weight (kg) by their height in meters squared.
The diagnosis of obesity involves calculating the patient’s body mass index (BMI). A BMI of 30.0 or more is considered obese. A BMI of 40.0 is considered extremely obese.
OBESITY TREATMENT OPTIONS
Reaching a healthy weight and then maintaining it is the goal of any obesity treatment regime. A number of professionals can aid in this process, such as:
- Behavior counselor
- Obesity specialist
Weight-loss regimes may consist of:
- Meal replacement therapy: Meal plans that recommend switching one or two meals a day with products such as low-calorie shakes or meal bars as well as eating healthy snacks.
- Exercise and physical activity: Obese people require at least 150 minutes of moderate-intensity exercise or physical activity to achieve the necessary amount weight loss.
- Change in behavior: With the aid of trained counselors and therapists, emotional and behavioral issues around over eating can be sorted out. Support groups are also another great form of support and understanding.
- Prescribed weight-loss medications: Prescribed weight-loss medication is intended to be used alongside a proper diet and exercise regime as well as behavior counseling.
- Bariatric surgery: This procedure may cause weight loss by restricting the amount of food the stomach can hold. This causes a malabsorption of nutrients or a combination of both gastric restriction and malabsorption. This procedure also often causes hormonal changes. Today, most weight loss surgeries are performed using laparoscopic surgery (minimally invasive techniques).
The most common bariatric surgery procedures are:
- Gastric bypass
- Sleeve gastrectomy
- Adjustable gastric band
- Biliopancreatic diversion with duodenal switch.
Each of these surgeries has its own advantages and disadvantages.
The Roux-en-Y Gastric Bypass also known as gastric bypass is considered the ‘gold standard’ of weight loss surgery.
HOW DOES A GASTRIC BYPASS WORK?
The procedure consists of two components, the first component involves a small stomach pouch that is approximately one ounce or thirty milliliters in volume, is created by dividing the top of the stomach from the rest of the stomach. Next, the first portion of the small intestine is divided and the end of the divided small intestine will be connected to the newly created stomach pouch.
The procedure is complete once the top portion of the divided small intestine is connected to the small intestine further down. The connection allowed the stomach acids and digestive enzymes from the bypassed stomach. The first portion of the small intestine will eventually mix with the food.
The gastric bypass works by several mechanisms. First of all, it is similar to most bariatric procedures. The newly created stomach pouch is much smaller and facilitates significantly smaller meals, which means fewer calories are consumed. There will be less digestion by the smaller stomach pouch and also a section of the small intestine will no longer have food going through it, thus there will be less absorption of calories and nutrients.
Most importantly, changes in the gut hormones due to the re-routing of the food stream will produce changes that promote satiety, suppress hunger, and reverse one of the primary mechanisms by which obesity induces type 2 diabetes.
WHAT ARE THE ADVANTAGES OF A GASTRIC BYPASS?
- Significant long-term weight loss (sixty to eighty percent excess weight loss)
- Amount of food that can be consume is restricted
- May lead to conditions that increase energy expenditure
- Favorable changes in gut hormones that reduce appetite and enhance satiety
- Typical maintenance of excess weight loss leas than fifty percent
WHAT ARE THE DISADVANTAGES?
- The operation is more complex than the AGB or LSG and has higher complication rates
- Potentially lead to long-term vitamin/mineral deficiencies deficits in vitamin B12, iron, calcium, and folate in particular.
- Typically has a longer hospital stay than the AGB
- Requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up compliance
The Laparoscopic Sleeve Gastrectomy – often called the sleeve – is performed by removing approximately 80 percent of the stomach. The remaining stomach is a tubular pouch that resembles a banana.
HOW DOES A SLEEVE GASTRECTOMY WORK?
Firstly, the new stomach pouch holds a considerably smaller amount than the normal stomach does and it helps to significantly reduce the amount of food that can be consumed, which means less calories are consumed. However, the greater impact seems to be the effect on the gut hormones. A number of factors including hunger, satiety, and blood sugar control are impacted.
As shown by short term studies, the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. Evidence also suggests that the sleeve is effective in improving type 2 diabetes without weight loss. The rate of complication falls between the adjustable gastric band and the roux-en-y gastric bypass.
WHAT ARE THE ADVANTAGES OF A SLEEVE GASTRECTOMY?
- Amount of food the stomach can hold is restricted
- Rapid and significant weight loss induced (studies find it similar to the Roux-en-Y gastric bypass)
- Weight loss of less than fifty percent for three to five plus year data, and weight loss comparable to that of the bypass with maintenance of less than fifty percent
- No foreign objects (AGB) and no bypass or re-routing of the food stream (RYGB) required
- A relatively short hospital stay of approximately two days
- Favorable changes in gut hormones that reduce appetite and enhance satiety
WHAT ARE THE DISADVANTAGES OF A SLEEVE GASTRECTOMY??
- Procedure is non reversible
- Potentially lead to long-term vitamin deficiencies
- Higher early complication rate than the AGB
THE ADJUSTABLE GASTRIC BAND
This procedure is also known as the band. It involves an inflatable band that is secured around the upper portion of the stomach. This creates a small stomach pouch above the band and the rest of the stomach below the band.
HOW DOES AN ADJUSTABLE GASTRIC BAND WORK?
Consuming a small amount of food will satisfy hunger and promote the feeling of fullness in the smaller stomach pouch. The level of fullness depends on the size of the opening between the pouch and the remainder of the stomach. Adjusting the band with sterile saline (injected through a port placed under the skin) can alter the size of the stomach opening.
Repeated adjustments are done gradually to reduce the size of the opening. The view that the band is a restrictive has been challenged by studies that show that food passes quickly through the band. Food remaining in the pouch above the band was not related to the absence of hunger or feeling satisfied. It is also known that there is no malabsorption so the food is digested and absorbed as it would be normally.
The impact of the band seems to be that it reduces hunger which in turn helps the patients to reduce the amount of calories consumed.
WHAT ARE THE ADVANTAGES OF A GASTRIC BAND?
- Amount of food the stomach can hold is reduced
- Excess weight loss of approximately forty to fifty percent
- No cutting of the stomach or re-routing of the intestines
- A shorter hospital stay (usually less than twenty-four hours, some centers discharge patients on the same day as the surgery)
- Reversible and adjustable
- Lowest rate of early postoperative complications and mortality among all the approved bariatric procedures
- Lowest risk for vitamin and mineral deficiencies
WHAT ARE THE DISADVANTAGES OF A GASTRIC BAND?
- Slower and less early weight loss than other surgical procedures
- Greater percentage of patients failing to lose at least 50 percent of excess body weight compared to the other surgeries commonly performed
- Requires a foreign device to remain in the body
- Possible band slippage or band erosion into the stomach (in a small percentage of patients)
- Mechanical problems with the band, tube or port (in a small percentage of patient)
- Dilation of the oesophagus if the patient overeats
- Strict adherence to the postoperative diet and to postoperative follow-up visits
- Highest rate of re-operation
For patients with a BMI 30 and above the following tests apply:
- Health history: A doctor will ask questions regarded weight history, exercise habits, weight-loss attempts, eating patterns etc.
- Physical exam: The patient’s height and waist circumference is measured and all vital signs are checked along with BMI.
- Checking for other health problems: If the patient has known health issues, the doctor will assess them as well as check for other conditions such as high blood pressure and diabetes.