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Tips & Articles

Women in city at high risk of obesity: Study

HYDERABAD: The incidence of obesity and overall cardio-vascular disease (CVD) risk among women aged between 35-44 years in Hyderabad is at an astonishing 57 per cent and 68 per cent respectively, revealed a three-year long Saffolalife study, India’s largest study on risk factors causing heart disease.

The study covered 1.6 lakh urban Indians across 12 metro and non metro cities in India.

Giving details of the study’s findings, Dr. Sridhar Reddy Peddi, consultant Interventional cardiologist, Apollo hospitals, said that 72% women respondents t in Hyderabad were found to indulge in less physical activity, more than 50% women had low high-density lipoprotein levels and 53% of women felt drained at the end of the day at least once a week.

The study explained that women in the city were at high CVD risk as 72% women respondents taking part in the study in Hyderabad were found to consume less whole grains, while more than 55% women in Hyderabad consumed fewer vegetables.

“CVDs in women are caused due to low HDL and high Body Mass Index. Apart from this, smoking, diabetes and high BP are other reasons putting women at risk,” said Dr Peddi, adding that sedentary lifestyles, stressful work and compromised diet also contribute in accelerating heart disease risk.

RESEARCH : WEIGHT LOSS SURGERY CAN REVERSE TYPE II DIABETES

Cleveland Clinic researchers presented results at the American College of Cardiology annual meeting in Washington, D.C. today from a study that showed stomach-reducing operations are more effective than medications for treating “diabesity,” the unhealthy combination of obesity and Type 2 diabetes. Published in the new issue of The New England Journal of Medicine, the study showed that the majority of patients who underwent surgery no longer needed insulin and other diabetes medications three years post-surgery. The diabetes-controlling success rate depended on the type of weight-loss surgery, but surpassed non-surgical treatment.

According to NEMJ research article, among persons in a prediabetic state, the incidence of type 2 diabetes is reduced by approximately 40 to 45% with effective lifestyle changes or drug treatment, and the effects persist, in part, 3 to 15 years later. Most trials of lifestyle changes and drugs for the prevention of type 2 diabetes have included moderately obese patients. However, patients with severe obesity have the highest risk of type 2 diabetes, and in this group, bariatric surgery is currently the only treatment that typically results in large, sustained weight losses. Although many studies have examined the effect of bariatric surgery on the remission of diabetes, there appears to be a paucity of studies examining the effect of surgery on the prevention of diabetes, possibly because a long follow-up period and a control group are required. The Swedish Obese Subjects (SOS) study assessed whether surgery can prevent diabetes.

Bariatric Surgery: An Answer to the Big ‘O’

Remember your New Year resolution? Most frequent resolutions are to become healthy, lose weight and look good. With resolutions fluttering between the desire to reach the ever elusive size 0, and just trying to stay within the healthy weight limits, people continue to look for an easy solution or, a ’quick fix‘ to achieve their goals.

The old fashioned way of diet control and rigorous exercise seems to be the mainstay at conversational level, but doesn’t seem to extend to practicality with everyone. Amongst us, there are those who suffer ailments and disabilities that prevent them from leading an active life.

The question on the table is – Is there an answer to the problem called the ’Big O’ or obesity?
In this age of nature cures, appetite suppressants, herbal products, magic diets with the promise of significant weight loss and self induced food deprivation to achieve the goal of ’weight loss,’ is there a solution that is proven and effective to achieve the weight loss goals?

Weight loss medications are limited by their side effects, length of time they can be used, lack of desired effect in some, and potential complications. Weight loss programs are wonderful if people can continue to follow the guidance provided, and stay with the suggested diet plans and exercise programs. The typical reaction seen is that the participants of such programs have regained their original weight – and then some more.

Why does this regaining of weight happen?
If people have the self control and will power to restrict their diet and mend their life style into a healthy pattern, the problem of obesity will not be so prevalent. On an average, India continues to have substantially lower percentage of population with obesity related issues compared to the western world; however, this population is on the rise. The IT sector jobs, call centers and the out-sourced positions from multinational companies are promoting sedentary lifestyles and sleep deprivation, with altered sleep-wake cycle in many of our professionals.

This in turn leads to poor dietary habits and inability to lead an active life, which then causes weight gain. Obesity is usually referred to in terms of BMI (Body Mass Index).
The consensus statement from world renowned organizations such as National Institute of Health (NIH), American Society for Metabolic and Bariatric Surgery (ASMBS) is that,
“Bariatric surgery is known to be the most effective and long lasting treatment for morbid obesity and many related conditions, but now mounting evidence suggests it may be among the most effective treatments for metabolic diseases and conditions including type-2 diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea.”

Surgical options for weight loss have been in existence for a few decades. This field of science has evolved significantly in the last decade, as obesity became a global epidemic. The availability of new technology and instrumentation that allowed for these procedures to be performed in a minimally invasive or laparoscopic approach, also contributed to this development. Surgical procedures are performed with very small skin incisions and camera guidance.

Some of those procedures are:
Laparoscopic adjustable gastric band placement
In this operation, a silicone gastric band is placed around the upper part of the stomach, creating a small pouch. The small size of the pouch means that you feel full sooner.
The band can be adjusted in size by inflating or deflating the band. This allows the health professional to adjust the size of the opening between the pouch and the stomach, and in turn can effectively control the amount of food required to obtain early satiety. Gastric band procedure is the simplest and safest of all weight loss procedures, and yields similar weight loss to all other procedures over a course of time.

Laparoscopic gastric sleeve resection
Approximately 85 percent of the stomach is removed during this surgery, leaving a narrow tube like stomach. Due to the very small capacity of the tubular stomach, less food can be consumed and early satiety achieved.

This procedure is irreversible and is relatively new with data of efficacy for past 3 years. This procedure, originally designed as an initial stage of another extensive surgery, has been shown to be effective for weight loss by itself.

Laparoscopic roux-en-y gastric bypass
This procedure combines the restrictive factor by reducing the amount of food that can be consumed, and adds the component of mal-absorption by re-routing the small intestine.

This procedure, till date, is considered as the ‘gold standard’ among weight loss procedures. It involves creation of a gastric pouch, which is completely separated from the remainder of stomach, and is re-attached to the small intestine. There is another additional attachment (anastamosis) between two loops of the small intestine to facilitate the flow of food material. Due to the component of mal-absorption, some may experience deficiency in vitamins, calcium, iron etc. These components can be supplemented successfully to avoid such issues.

Regardless of the procedure performed, the efficacy of these surgical procedures is currently unquestionable. The picture below suggests the significant improvement in quality of life after such surgeries.

As time moves forward with relentless fervor, do not wait for the next New Year eve ball to work towards the resolutions you already made to improve your quality of life. Make every day count towards your success in achieving your personal goals.

Metabolic Syndrome

Are you worried about being overweight, and not being able to lose it? Have you gone through diets, exercise programs, medicines for weight loss without success? Have joint pains or back pain due to excess weight? Are you having menstrual irregularities, infertility or polycystic ovarian syndrome while being overweight? Have been told by your doctor regarding your high blood fat content, high blood pressure and diabetes?

If you do, then, this article is meant for you. More than being just overweight, even more dangerous is the obesity related metabolic syndrome. It is an inflammatory reaction that occurs in the body due to excess fatty tissue.It is a danger lurking in shadows; it is not as well known as the other conditions like heart disease, high cholesterol or high blood pressure. But, this certainly is a more destructive condition which affects several body organs and leads to many diseases.

What is metabolic syndrome?
Abdominal obesity (excessive fat tissue in and around the abdomen)
Blood fat disorders —

1. High triglycerides,
2. Low HDL cholesterol and
3. High LDL cholesterol

These conditions increase plaque buildups in artery walls.

1. Elevated blood pressure
2. Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
3. Pro-thrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
4. Pro-inflammatory state (e.g., elevated c-reactive protein in the blood)

Other associated diseases and signs are:

1. Fatty liver (especially in concurrent obesity) progressing to non-alcoholic fatty liver disease,
2. Polycystic ovarian syndrome (in women), and
Acanthosis nigricans (a brown to black, hyper-pigmentation of the skin. Usually found in body folds, such as the folds of the neck, the axilla, groin, umbilicus, etc.)

How is the metabolic syndrome diagnosed?
The American Heart Association and the National Heart, Lung, and Blood Institute recommend that the metabolic syndrome be identified as the presence of three or more of these components:
1. Elevated waist circumference:
>> Men — Equal to or greater than 40 inches (102 cm)
>> Women — Equal to or greater than 35 inches (88 cm)
2. Elevated triglycerides: Equal to or greater than 150 mg/dL
3. Reduced HDL (“good”) cholesterol:
>> Men — Less than 40 mg/dL
>> Women — Less than 50 mg/dL
4. Elevated blood pressure: Equal to or greater than 130/85 mm Hg
5. Elevated fasting glucose: Equal to or greater than 100 mg/dL

How do you manage metabolic syndrome?
The primary goal of clinical management of the metabolic syndrome is to reduce the risk for cardiovascular disease and type 2 diabetes. For that,
1. Stop smoking
2. Reduce LDL cholesterol
3. Reduce blood pressure and glucose levels to the recommended levels.
4. Weight loss to achieve a desirable weight (BMI less than 25 kg/m2)
5. Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week

Healthy eating habits that include reduced intake of saturated fat, Trans fat and cholesterol If above measures fail, the next treatment is weight loss surgery (bariatric surgery).

The consensus statement from world renowned organizations such as National Institute of Health, American Society for Metabolic and Bariatric Surgery is that, “mounting evidence suggests bariatric (weight loss) surgery may be among the most effective treatments for metabolic diseases and conditions including type-2 diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea. Surgery for severe obesity goes way beyond weight loss. This surgery results in the complete remission or significant improvement of type 2 diabetes and other life-threatening diseases in most patients.

Do not let the overweight and related problems steal the quality of life from you. Every day counts; enjoy the little pleasures in life. Live life to the fullest and do what it takes to make it better.

FAQs on Bariatric Surgery

Medical science describes obesity as a condition when the amount of fat stored in a human body exceeds healthy limits. Obesity itself is a disease. Additionally, it provides ideal condition for degenerative diseases to take hold of a body, and reduce life expectancy.The good news for those who are battling the battle of the bulge is that there is now a solution in the form of weight loss surgery.

Why do some people need bariatric surgery?
Obese individuals are at far greater risk of dying of an obesity-associated disease (such as diabetes, heart disease, arthritis, respiratory disease and others). Obesity accounts for more than 280,000 deaths annually in the United States, and will soon overtake smoking as the primary preventable cause of death, if current trends continue. This trend is at an alarming rise in India.

Weight loss by conventional therapies, such as diet, exercise, behavioral modification, or by anti-obesity medications, have a less than one-percent long-term success rate for obese individuals. Weight-loss surgery can help the morbidly obese achieve long-term success.

What is the difference between being overweight and being obese?
By definition overweight is a body mass index (BMI) of 25-29 and obesity is defined as a BMI greater than or equal to 30.

What are the various surgical options?
All of these procedures can be performed in a minimally invasive fashion (laparoscopic). They are,

1. Adjustable Gastric Band
2. Gastric Sleeve
3. Roux-en-Y gastric bypass

Choosing between the procedures involves many factors, including the patient’s preference and consideration
of the patient’s eating habits. The final decision is best made as a team effort when discussed between the patient and the surgeon. An ideal center will have clinical staff that has extensive training, experience, and excels in managing postoperative surgical complications.

How much weight can I expect to lose after gastric bypass surgery?
The difference in weight loss can vary according to the motivation of the patient and the procedure he or she chose. Usually, those who choose the gastric band procedure experience a more gradual weight loss compared to those who opt for the gastric bypass procedure.To some, it will be advantageous since it offers time to regain skin tone. Gastric-bypass patients achieve a quicker weight loss in the initial phase.

Regardless of the procedure chosen, the weight loss is similar at the end of 2 years time.

How long will I be in the hospital?
Length of hospital stay for either an open or laparoscopic gastric bypass surgery is about a two to three days, and less than 24 hours for a gastric band patient. The time spent in the hospital depends upon the individual, his or her co-morbidities, and whether or not there are complications.

What happens to my excess skin?
The amount of excess skin depends on the total weight loss, age, whether the person smokes and how much the skin was stretched. About 25% of patients elect to have plastic surgery.

Childhood Obesity: How Parents Can Help

As I walk into my son’s school to attend an annual celebration, it is immediately noticeable that a significant portion of school children are overweight.

This reflects the trend of weight changes in school children across most urban schools and so called ‘premier league schools’ in India. A hefty child used to mean a healthy, well-fed child. But, this may be another form of malnutrition. Unfortunately, while some children in our country are struggling with hunger and poor nutrition, we have another emerging problem…”The problem of plenty”. It is currently an acceptable norm to have overweight kids in well-to-do families.

Here are some sobering facts:

>> It is very likely that overweight children will become overweight adults.
>> The probability of childhood obesity continuing into adulthood is estimated to increase from approximately 20% if they are obese at age four to almost 80% by the teen years.
>> Pediatric (childhood) obesity is increasing at an alarming rate, making it a major concern for today’s youth.
>> Approximately, 15% of children in India, ages 6 to18 years old, are considered obese.
[Obesity is measured in terms of Body Mass Index (BMI), a ratio of weight (in kilograms) divided by height (in meters squared)]
Causes of obesity in children:
Causes of pediatric obesity differ from child to child and are still not fully understood. Factors such as genetics, environment and behavior seem to be the main causes.
Overweight children are at increased risk of developing:
>> High blood cholesterol
>> High blood pressure
>> Type 2 diabetes
>> Sleep apnea
>> Asthma
>> Orthopedic complications

Recently, at my practice, I was shocked to see a 14 year old boy with a weight of 93 kgs and severely hypertensive. Parents of this child approached for a possible .

weight loss procedure to help his overweight and hypertension. It is only a matter of time that he will develop type 2 diabetes and other conditions mentioned above, if nothing is done.

Our role as parents
It has been shown that children with overweight parents are more likely to be obese. Experts believe that this is a leading cause for childhood obesity. Regardless of how big a role genetics plays, one thing remains very clear…

Parents are responsible for a child’s genes, diet and behavioral patterns.
The goal for obese children should be to maintain weight or reduce the rate of gain. Excessive calorie consumption and lack of physical activity are two of the major culprits and are controllable risk factors. Parents should take a pro-active role by asking their health care provider or school authorities to monitor their child’s BMI periodically (a least once a year).
At home, remember that parents and caregivers are a child’s best role model. If you’re staying active and eating a balanced diet, your children are more likely to follow your lead.

Open Mind

Enlightenment comes from completely understanding yourself.
With an open mind, discover what’s hidden inside you
Obesity is not a state of being; it is a health condition the needs medical attention. Weight increases over years due to hectic lifestyle and continues to take the toll on our bodies with early onset of health issues like Hypertension, Diabetes, Arthritis, Sleep apnea etc. With every increase in weight, the determination to improve our health diminishes. People resign to their weight and continue to live with very little confidence.

It takes an open mind to recognize obesity as a health condition and seek medical help to address the condition.

At LivLife our Multi Specialty approach not only helps you lose weight but also helps you manage your life better. Welcome to LivLife, you discover the real you.

Knowledge

With this knowledge, be empowered to unveil your finest qualities
Each body is unique. Many conditions like hormonal imbalance, hereditary conditions, poor diet choices and lack of physical activity over a long period are responsible for weight gain and obesity. Not all weight gain and excess weight can be conquered with exercise and diet therapy.

Bariatric surgery may be the next step for people who remain severely obese after exhausting all non-surgical approaches or for people who have an obesity-related illness. Bariatrics deals with weight loss on evidence based methods, which include conservative and interventional and provide long lasting results.

You may be a candidate for surgery if you have a body mass index (BMI) of 37 or more; or a BMI of 32 and above and a serious obesity related health problem, such as high blood pressure or Type 2 diabetes. Click here to calculate your BMI.

Commitment

Quality of life can be measured by your commitment to making it better

Embark on a journey to renewed life
Bariatrics tackles several medical conditions that are associated with being overweight. Significant improvement or resolution of these conditions can be obtained by losing excess weight and by a patient’s commitment.

LivLife is committed to help you fight your obesity and weight related issues. At LivLife, a range of services equips you to manage post operative lifestyle including stress, diet, fitness and relaxation.

To know more about Post Operative support,
contact our counselor at

Phone: +91 40 3088 8888
Email: life@livlifehospitals.com