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OBESITY

Obesity


What is Obesity?

Obesity is defined as an excessively high amount of calories. It is commonly measured by Body Mass Index (BMI) which calculates the relationship of weight to height.

cims obesity

Classification of Obese Patients


 

BMIWeight Status (International)Weight status(India/ Asia)
Below 18.5UnderweightUnderweight
18.5 – 24.9Normal18.5-23.5
25.0 – 29.9Overweight23.5-27.5
≥ 30.0Obese≥ 27.5
≥ 40.0Extreme obesity / Morbid obesity≥ 35

How to calculate BMI?


CIMS tool helps you to find your Body Mass Index (BMI) from your height (inches and feet)
and weight(kg) data.

 

OBESITY PUTS YOUR HEALTH AT RISK

cims obesity

Causes


Main cause of obesity is “increased intake of calories”.

Other Causes are defined below:

  • Energy Imbalance: Energy consumed is higher than the energy burnt.
  • Genetics: Obesity can often be traced to genes, and it runs in family. Your chances of obesity are higher if one or both of your parents are obese.
  • Illness/Disorder: Hypothyroidism, Cushing Syndrome and Depression
  • Psychology: Mental illness and emotional problems
  • Drugs: Certain drugs like steroids given for diseases like Asthma may lead to gain in weight
  • Sedentary life style: At workplace and at home, if you have work which requires very less or almost no physical efforts, you may become obese

Treatment


At CIMS Bariatrics center, variety of surgical options are available depending on the patients’ needs. Laparoscopic (Minimally invasive) nature of surgery makes it safer and a more effective technique with reduced length of stay and ability to soon restore routine life.

  • Sleeve Gastrectomy
  • Gastric balloon
  • Lap adjusted gastric bands
  • Gastric bypass (RNY)
  • Mini-Gastric bypass
  • Single port surgery

Sleeve Gastrectomy


cims obesity

  • Restrictive procedure to reduce size of stomach and thereby limiting food intake
  • Thin vertical sleeve is created from stomach by a stapling device, capable of holding quantity of 50 to 150 ml-merely about a size of banana
  • The excised portion of stomach is removed while keeping the outlet valve (pylorus) intact so as to preserve stomach’s usual functions.
  • Note: There is no intestinal bypass or malabsorption with this procedure, but only stomach reduction.
  • Advantages: Food passes through the digestive tract in the usual way, allowing vitamins and nutrients to be fully absorbed into the body; so no deficiency. It also provides good appetite suppression
  • Risks: In addition to the general risks of surgery, gastric leaks and staple line bleeds may occur.

Gastric Balloon


cims obesity

  • Non-surgical method of treating obesity
  • Soft, expandable, silicone balloon placed inside the stomach with endoscopy in side stomach via mouth with/without sedation
  • Outcomes:
    • Earlier satiation (feeling full) to deter person from overeating
      • Lessens hunger and enables effective diet planning
  • Duration: 6 months , then after removal as per advised by nutritionist
  • Benefit : 10-12 kg weight reduction within 6 months

Laparoscopic Adjusted Gastric Bands


cims obesity

  • It is a restrictive procedure, which includes gastric band placement around the stomach. It divides stomach into two parts: 1. Small upper pouch and 2. Lower pouch.
  • As upper pouch holds ½ a cup of food, the person feel fullness of stomach sooner and for longer duration
  • Risk: Patients with gastric banding may develop gallstones (stones in gall bladder).Thus, it is recommended to have Cholecystectomy (Surgical Removal of Gallbladder)
  • Benefit : 10-12 kg weight reduction within 6 months

Gastric Bypass


cims obesity

  • Combinational technique aimed at restriction and malabsorption
  • Step-1: Small pouch of approx. 15-20 cc created using staples with remainder of stomach without removal so as to continue secretion of gastric juice.
  • Step-2: Lower intestine is divided into a certain portion.
  • Altered digestive process: Upper part of intestine is bypassed by ingested food while passing through the jejunum.
  • Benefit: Delay in mixing with gastric juices of ingested food reduces complete calorie absorption, thereby more reduction in excess weight than other restrictive surgery options
  • Advantages: 1.No postoperative adjustments required as in bands. 2. It helps resolve type2 diabetes, high blood pressure, and sleep apnea and improve high cholesterol levels.
  • Risks :
    • In addition to the general risks of surgery, there could be Vitamin, Calcium and Iron deficiencies and associated illnesses/disorders due to poor absorption attributed to bypassed jejunum.
    • Dumping syndrome: as Pylorus is bypassed, weakness, abdominal discomfort, and sometimes abnormally rapid bowel evacuation occurs after meals in some patients who have undergone gastric surgery.

Mini Gastric bypass


  • This is a therapeutic variation in terms of the bypass route of food and gastric juices as shown in figure below:
    cims obesity
  • Advantage: This easily revisable/reversible method has shorter duration of surgery and comparably reduced length of stay to those associated with gastric bypass. It also provides minimal pain. This has potential to result in minimized risk due to lesser anastomoses of intenstines, ease of surgery and long term good weight loss.

Single port surgery


  • Single port is used for incision in belly in this surgery of minimally invasive nature.
  • The surgery is done by means of laparoscope under general anaesthesia
  • Main incision is made through navel with 3-4 additional small incisions (ports) around it, which could be used to remove a kidney or to repair the urinary tract.
    cims obesity
  • Advantages: Little to no scarring and may reduce complications that commonly occur after traditional open surgery and even laparoscopic abdominal surgery. Patients are reporting less discomfort and faster recovery compared with those undergoing traditional laparoscopy.

CIMS Cases


  • A 60 years old female patient with grade-3 obesity (Weight- 110 kgs, Height – 157 cms, BMI 44.6) with complaints of pain in joints and difficulty in walking was counseled and operated for reducing size of stomach. As a result, patient was able to reduce more than 20 kgs of her body weight within period of 4 months and was now able to walk without stick. There was no reporting of any adverse event during and after this surgery.
  • A 34 years old male patient with excessive weight gain in previous 4-6 months (Weight 117 kg) with known case of hypertension for previous five months with enlarged liver due to fat was operated for reducing stomach size. The patient was discharged with stable haemodynamics with uneventful post-op recovery. Upon follow-up, patient was found to have reduced his weight to 89 kg in four months.
  • A morbidly obese, 43 years old, male patient (Weight-148 kg) was admitted at CIMS with breathlessness, sleep disturbance and skin infection resulting from multiple folds with history of hypertension, diabetes and joints pain. Stomach size was reduced with uneventful post-op recovery with gradual weight loss observed during follow-up visits. After 41/2 months, patient was found to have reduction in weight by 36 kg with controlled blood pressure and blood sugar without use of any medications. There were also no further complaints of fatigue, breathlessness or joint pain.
  • A 64 year old, female patient (Weight-100.4 kg, Height-152 cms, BMI-43.3) with known case of Rheumatoid arthritis for previous ten years and on-going medications for the same was operated for size reduction of stomach with gradual weight loss, tapering and subsequent stoppage of Rheumatoid arthritis medications. Patient was pain-free within a period of 3 months post-surgery and only occasionally required analgesics for knee pain with ability to ambulate without the support of stick. By the end of 12 months, total weight reduction attained by the patient was 32 kgs.

Doctors in Attendance


 

 

CIMS Hospital
Care Institute of Medical Sciences
Off Science City Road, Sola, Ahmedabad – 380060
Gujarat, INDIA

24x7 Helpline +91 70 69 00 00 00
Phone: +91 79 2771 2771 or 72
Fax: +91 79 2771 2770
Mobile: +91 98250 66664 or +91 98250 66668
Ambulance: +91 98244 50000
Email: info@cims.org or info@cims.org

CIMS Hospital was awarded being the best hospital in Gujarat for 2019 by the International Health Care Awards.

CIMS Hospital is a 350-bedded, multi-super speciality and regarded one of the best multi-speciality hospitals of Ahmedabad in Gujarat providing a range of diagnostic and treatment services.  

CIMS Hospital has been awarded best hospital for quality in service delivery award at the ABP News presents Healthcare Leadership Awards 2015 held at Mumbai.

CIMS Hospital has been recognized as the Times Health Icon 2018 for being the best Hospital for Oncology and Critical Care. CIMS Hospital also was rated the Best Multispecialty Hospital in Gujarat at the International Healthcare Awards, 2018 held in Delhi. 

CIMS Hospital provides world-class treatment and healthcare services in India and the leading heart hospital in Ahmedabad, Gujarat. CIMS Hospital offers the highest quality services and offers treatment to most diseases and medical problems with one of the highest success rates in India.

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