Diet and exercise are taxing on the mind. It is simple to say and hard to follow, says a foodie. Hence the obese and super obese try and hunt for a simple solution where they don’t have to taste their patience, motivation and will power.

But they forget that weight loss surgery isn’t a miracle procedure — and it isn’t for everyone.Weight loss surgery isn’t an alternative to diet and exercise—it is an addition to diet and exercise. Although for few,who have a crippled life with complications of severe obesity, it can improve the quality of life.

Different kinds of diets, gyms, slimming centers using various lipolysis machines and weight loss surgeries; all have started advertising and marketing their products and services.

Putting before and after pictures and inviting celebrities, local or national for mass awareness is a trend. This keeps people confused. What to do now? A simple solution would be just to categorise your weight and try to find a simple way out, one step at a time.

Look at the criteria given by medical authorities for bariatric surgeries( Weight Loss Surgeries).

  1. Efforts to lose weight with diet and exercise have been unsuccessful.
  2. Body mass index (BMI) is 40 or higher.
  3. Your BMI is 35 or more and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea.
  4. You’re a teenager who have gone through puberty, your BMI is 35 or more, and you have serious obesity-related health problems, such as type 2 diabetes or severe sleep apnea.

Now let us discuss this –

Diet and Exercise is the main treatment even if you think of surgery or not. But there is no authority, national or international to say that you follow this kind of diet and exercise for effective weight loss. There is huge quackery involved in this kind of treatment.

All the treatments of diet and exercise, if given by expert doctors and dietitians trained in obesity management are more effective and trustworthy. They can actually help you to reach such a stage where weight loss surgery may not be of need. Reducing just 20 percent of the required calories in the total food intake and walking for 90-120 minutesevery day; continued for a longer period of time ( mind well that you have taken many years to become super obese ) will solve almost all the problem.

Consult a doctor or trained dietitian, experienced in obesity management. Cross check, all of them are not trained or experienced in it which may be a reason for you to not lose weight. If you are visiting a cardiologist for a heart problem and an orthopedic surgeon for Bone and joint issues, for weight loss, isn’t it logical to consult a Doctor or Dietitian trained in Obesity management?

What is BMI and what BMI 35 or 40 mean? BMI is body mass index, a key index for relating weight to height. BMI is a person’s weight in kilograms (kg) divided by his or her height in meters. We will consider two examples. One is 150 cms and other is 180cms.

Height BMI 25 BMI 30 BMI 35 BMI 40
150cms 56kgs weight 68kgs 78kgs 90kgs
180cms 82kgs weight 98kgs 114kgs 130kgs

Now a person who is 150 cms, male or female require to lose 34 kgs( 90kgs – 56kgs ) of weight to come to near normal weight. But does he really require to come to that weight, absolutely not? Medical science says even 20-25% weight reduction in the existing weight will give many major health benefits in terms of controlling diabetes, Heart disease and Sleep apnea which are life-threatening. So for this kind of weight loss even if people follow lifestyle change, diet and exercise are more than sufficient. This point is very important and each and every obese person should think twice, follow lifestyle change and make their life simple.

Medical Science says people at this weight and with other disease conditions should avoid exercise and just do the walking. The only key is that they should consult a trained doctor or dietitian and follow them for at least a year before thinking of weight loss surgery. People keep on jumping with different kinds of diets and exercise methods and land into a psychological state where they start thinking that weight loss is impossible. Butwe truly believe this state can be reversed slowly and steadily, permanently.

Similar is the case of a person with height 180cms.At this height, obese people look huge and hence they easily fall prey for weight loss surgeries.We sincerely feel that they should give a try with 100 percent efforts before going for a surgery. People above 150 kgs weight, and have health issues causing difficulties in managing their daily chores should directly opt for surgery.

Having gastric bypass or other weight-loss surgery doesn’t guarantee that you’ll lose all your excess weight or that you’ll keep it off over the long term. Nor is it a way to avoid making changes in your diet and exercise habits. In fact, you can regain the weight you lose with surgery if you don’t stick with the lifestyle changes.

No matter which weight loss surgery you choose, the procedure is expensive and will require that you make big changes to your lifestyle. As with any surgery, there are pros and cons of the surgery and anesthesia to consider. In some cases, the impact on your life may make you wonder if it is truly worth the cost and risks. ‘Life after weight loss surgery isn’t what I had expected’, says Soham, the person who underwent surgery 3 years before.

‘It has changed my appetite, and even my lifestyle and social life’. The changes often come as a surprise to people who hoped that the surgery might offer an easy way out of their weight loss problems. In fact, good eating habits and regular exercise become even more important after bariatric surgery. For some, the commitment is more than anticipated. ‘ My friends have stopped inviting me for the party’s, says Geeta, another weight loss surgery candidate. I was very emotional and the food was my stress buster. After the surgery, I am getting even more stressed as I can’t eat. I feel I should have tackled my relations with food early before thinking of weight loss surgery. Surgery can’t be undone now.

Multiple surgeries are sometimes needed and are not uncommon. Moreover, the cost of surgery can often be exorbitant anywhere between Rs.1.5 lakhs to Rs.5 lakhs. While the success rates for weight loss surgery continue to improve, some weight regains in the years after bariatric surgery is very common. According to the American Society for Metabolic and Bariatric Surgery, most weight loss occurs in the first two years following surgery. While weight regain is common after five years, most are able to keep 50 percent of the excess weight off. All surgeries have risks and benefits to consider. It has also shown to be effective at reducing the impact of many obesity-related conditions such as type 2 diabetes, sleep apnea, and heart disease. If you have decided to go for surgery,do your study prior to surgery.

Talk to different bariatric surgeons about which procedure to choose and other details. But Unfortunately, many surgeons do not give their patients time to prepare for the physical and psychological changes that lie ahead. In this case, speak with someone who has had undergonebariatric surgery, you will get true feedback.

(Disclaimer: Writer is Dr. Kiran Rukadikar, Chairman, Bariatric Physician & Obesity Consultant

 Liven Healthcare Pvt. Ltd.)



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