MORBID OBESITY AND ITS MANAGEMENT

Morbid obesity means excess body weight that causes many diseases and reduces longevity.

It is objectively defined as a BMI of 40 or more. BMI is Body Mass Index.

It is measured as follows:

BMI = Weight (in kg)
Height(m)2
BMI effectively gives us an objective parameter to measure an individual’s state of obesity, relative to his height. If the BMI is more than 40 kg/m2, the condition is known as morbid obesity. In such a state the patient is prone to develop diabetes, hypertension, obstructive sleep apnea, arthritis, gallstones, reflux disease, hernias, cancers, etc. The average longevity of such a clinically severe obese person is cut short by 10-14 years. Indians have a higher proportion of body fat and less bone mass compared to Caucasian and African races. For this reason, the BMI parameters for defining obesity are a little less. For example, in India, a BMI of 37.5 would be the yardstick to call a person morbidly obese. In India, around 15 percent of the population is overweight or obese. Around 5 million people are morbidly obese.
Scientific studies have shown that in this group of patients, supervised weight loss programs using diet and exercise have a failure rate of 95% when it comes to assessing sustained weight loss. Drugs achieve a weight reduction of only 10% at most, and the benefits cease as soon as the drug is withdrawn. In addition, there are side effects of these. The only proven method of weight loss in morbidly obese individuals is Bariatric surgery. This surgery may be of two different types: restrictive (where the capacity of the stomach to store food is restricted), and malabsorptive (where the digestion of fats is hampered). The most common operations are Laparoscopic Gastric Bypass (LGB), Laparoscopic Adjustable Gastric Banding (LAGB), and Sleeve Gastrectomy.
Benefits of the surgery include 70% weight loss in two to six months that is sustained in life, cure of diabetes in 85% of patients, cure of hypertension in around 60%, and cure of snoring in around 90%.
In Kolkata, this kind of surgery is available at Wockhardt Hospitals.

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