Management Of Obesity

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Management Of Obesity

To manage obesity, one needs to measure it, so that doctors can decide on a patient-specific regimen for the treatment. Body mass index (BMI) is the most accepted obesity measurement tool. Patients with a BMI between 25 and 29.9, who are considered overweight, benefit from diet and exercise. But for patients whose BMI is 30 and above, only diet and exercise are not helpful and for long-term sustained weight loss, such patients need surgical weight loss methods which are clinically proven and safe.

The biggest challenge that the obese people face is the craving for more food, which is due to the hormone ghrelin secreted by the stomach. Unfortunately, there are no pills that doctors can prescribe to overcome the effects of this hunger hormone.

The solution is surgery, which has become simple and safe due to the laparoscopic approach.

Laparoscopically, the hunger hormone-producing area of the stomach can be removed and the size of the stomach can be reduced making it like a tube so that the food intake is minimised. The procedure is called vertical sleeve gastrectomy and is a great blessing for morbidly obese people who have a high BMI. This is usually done for those with BMI over 40 or those with BMI over 30 with associated diseases like diabetes, hypertension and others. The weight loss is dramatic and permanent. One loses about 60% of excess weight in a graded fashion over a year or so. In the meantime, it is important to be committed to a healthy way of life, eating a low-calorie diet and doing regular exercise for the rest of one’s life.

Options available

1. Dietary counselling: Proper counselling helps obese individuals realise that weight loss is a slow and gradual process that requires hard work and commitment. So, one should be strong and patient to follow the right weight loss plan. A dietician tailor-makes a diet plan to suit individual tastes and cultural needs. It usually includes:

  • Limiting energy intake from total fats and shifting fat consumption away from saturated fats to unsaturated fats and towards the elimination of trans-fatty acids.
  • Increasing consumption of fruits and vegetables and whole grains and nuts. Adults should consume at least 500 gm of fresh fruit and vegetables a day.
  • Limiting the intake of free sugars and salt (sodium) consumption from all sources. Recent guidelines recommend eating less than 1,500 mg of sodium per day.

2. Exercises under supervision: Because obese individuals are carrying more weight, activities they participate in have the potential to place a significant amount of stress on their ankles, knees, hips and lower back. Engagement in activities that put minimal stress on the joints, such as walking, swimming or water exercises and cycling is suggested. Easing into a workout is recommended. One is advised to start slowly for the first five minutes to give the body time to adjust to the activity. Working at a comfortable pace that allows talking without too much difficulty, is advised.

3. Liposuction: It is not a good treatment of obesity. Liposuction is not effective, even as a last resort. For people who are unable to lose weight through diet and exercise, it is not safe to remove huge amounts of fat by liposuction. It is dangerous to remove more than 8 to 10 pounds of fat by liposuction in a single day.

4. Weight loss surgery