Bariatric Surgery - An ultimate solution for morbid obesity, worldwide

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Dr. Vinod K. Singhal

Posted By : Dr. Vinod K. Singhal - MS,FACS, FAIS, FICS (Surg. Gastro), FMAS, FIAGES

Posted On : Oct 18, 2007 (Views : 4390)

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Obesity has become a global problem now. Earlier it was considered to be the disease of high class society or people who are rich but surprisingly it is becoming more and more common in middle class and neo-rich class in our country. It is assumed that there are about 1.5 million people in our country who are coming into the group requiring surgical intervention for the control of obesity. ?



Globesity
?  has occurred much faster than can be explained by genetic factors alone. Changing lifestyle has to be the major explanation. Easy availability of calorie rich fast food is as important as sedentary life style like use of vehicles, computer games, TV, use of lifts and elevators and lake of exercises, along with depression are major factors causing it.


 


To counter worldwide obesity, World Health Organization in May 2002 urged member nations to formulate the global strategy on diet, physical exercise and health (World Health Assembly Resolution 55.23) with the mandate to complete prevention guidelines by 2004.




Obesity leads to type II Diabetes, high blood pressure, stroke, heart and vascular diseases, joint problems, gall stones, urinary incontinence, sleep disorders, psychosocial problems, several types of cancers like endometrial, breast, prostate and colon cancers. It also leads to infertility, impotence and PCOD in females.


 


Whether a patient is obese or not, is decided on the basis of his or her BMI (calculated as Weight in kilograms / height in meters square). Healthy weight is considered when  BMI is between  19 and 24. A person is Overweight when    BMI is 25-29, Obese (BMI 30-39.9), Morbidly Obese    (BMI    >40) and Super Obese when BMI is more than 50.


 


There have been different options described for the management of obesity including dieting and help of exercises. Unfortunately none of them have shown permanent solution for the relief of the problems and it has also been seen and described as well that, patient gain more weight than it started before the weight loss program (Yo-Yo effect of dieting) which is more dangerous.


 


Bariatric or Obesity surgery was started long back (about 50 years back) for the control of morbid obesity and has now become the most sought after solution for it. Considering variations in  a operation it would not be exaggerating to mention that up to 100 operations have been advocated and practiced. Laparoscopy entered into Bariatrics in late 1990s and has dominated bariatric surgery in current era.


 


It is considered for patients who have BMI more than 33 with certain medical diseases or BMI more than 37 without other associated diseases. There are various options available like, Gastric Banding, Roux-en-Y gastric bypass, Sleeve gastrectomy, Bilio-Pancreatic Diversion etc.


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