Max Hospital India

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Department of Endocrinology, Diabetes and Obesity
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Department of Endocrinology, Diabetes and Obesity
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International Patient Services
You’ve come to the right place!

Since our inception in 2001, affordable quality healthcare has been our focus. Your well being is the most important aspect in our mission. You are well taken care of the moment you step on Indian soil.

We are the primary choice of physicians in India, being known for our timeless ethical practices. As a recognised leader in quality healthcare in India, we are leveraging this advantage for patients the world over.
How do we take care of you?
Transfers between the airport and the hospital
Currency exchange and wire transfer facility
Internet connectivity
Car-hire facility
Choice of international cuisine
Regular updates on the patient's progress
Post-discharge query handling
Assistance at the Foreign Residents Registration Office (FRRO)
Visa assistance
International insurance facilitation help desk
Initial screening and diagnosis
Diagnostics and treatment at the hospital
Travel arrangements to Delhi on a turnkey basis - including visa, ticketing, pick-up at the airport, money transfer and exchange, ATM withdrawals
Interpretation services
Exclusive ‘Help Desk’ and a dedicated Relationship Manager to ensure smooth services
Boarding and lodging assistance to suit range of budgets
All arrangements for return journey
Bariatric Surgery Packages - Obesity
We look at overweight and obesity from a different perspective as health professionals and provide a solution which will be different from what you get on your daily newspaper and leaflet.
Obesity is when a person is carrying too much body fat for their height and sex. A person is considered obese if they have a Body Mass Index (BMI) - weight in kilograms divided by their height in metres squared - of 28 among Asians and 30 for Caucasians.
Asians with a BMI between 23 (25 for Caucasians) and 28 (30 for Caucasians) are categorised as overweight, and those with an index above 28 are categorised as obese. People with a BMI of 40 or more are described as morbidly obese.
Your waist circumference may also help us to assess your risk of developing obesity-related health problems, such as heart disease. Adult obesity rates have almost quadrupled (become four times as great) over the last 25 years.
Obesity can take up to nine years off your lifespan. It also makes you far more likely to develop a range of health-related problems than just cosmetic issues, including:
Diabetes
Heart disease
Stroke
Osteoarthritis
High blood pressure
Gallstones
Infertility
Depression
Cancers of the colon, breast, kidney and stomach
Many people may also experience psychological problems, such as:
having low self-esteem (self-worth) - or poor self image
having low confidence levels
feeling isolated in society
having reduced mobility leading to a poor quality of life
Causes
Obesity does not just happen overnight - it develops gradually from poor diet and lifestyle choices and to some extent, from your genes.
Lifestyle choices
Eating more calories than you need may lead to poor food choices - for example, eating high fat, processed or fast foods rather than filling up on fruit, vegetables and unrefined carbohydrates, such as, wholemeal bread and brown rice. Alcohol also contains a lot of calories and heavy drinkers are often overweight.
Bad eating habits
Bad eating habits also tend to run in families - rather than inheriting a slow metabolism. The habits learnt from your parents can be an important factor. Childhood obesity is a strong indicator of weight-related health problems in later life, showing that inherited unhealthy lifestyle choices continue into adulthood.
Lack of physical activity
Lack of physical activity is another important factor that is related to obesity.
Genes and family
Some people tend to stay the same weight for years without much effort, whereas others find they put on weight quickly if they are not careful. This could be due in part to your genes - scientists have discovered certain genes that make you feel hungrier or make it take longer for you to feel full.
Medical reasons
In less than one out of every 100 cases, there is a medical reason for obesity. Conditions such as Cushing's syndrome (over-production of steroid hormones in the body) and an under-active thyroid gland are rare causes of weight gain.
Certain medicines, including some steroids and antidepressants, can contribute to weight gain. Also, taking the contraceptive pill and quitting smoking may increase your appetite.
Diagnosis
Body Mass Index (BMI) is currently used as the most accurate and reliable way of measuring how overweight you are.
You can work out your own BMI using this calculation:
1. Measure your height in metres and multiply the number by itself - this is the squared figure
2. Measure your weight in kilograms
3. Divide your weight by the answer you got in step 1 (squared height)
4. The number you are left with is your BMI

For example, if you are:
1.65 metres tall (165cm - 65 inches), your squared figure is 2.72
58 kg in weight
58 kg divided by 2.72
21.3 BMI figure
For most people, an ideal BMI is between 18 and 23.
Treatment
The best way of tackling obesity is to reduce the amount of calories that you eat and exercise more.
Most you know who diet either regained weight back or failed to achieve significant weight loss. We have designed the combination of diet and exercise along with pharmacological treatment.
Bariatric surgery can be an excellent choice for some patients and can reduce significant weight.
Medication
The part of the brain that controls how hungry we are is called the hypothalamus. It controls the hormones and chemical signals circulating in our blood that influence appetite.
Sibutramine (obego) and Rimonabant (oberim) have been recommended internationally and can cause weight reduction of up to 10% in 3 months in majority of cases. However, this needs to be discussed with us before it can be started. There are some side effects, but the benefits may outweigh them in most patients.
Orlistat (obelit), works by blocking the action of body chemicals called enzymes which digest fat. The undigested fat is not absorbed into your body and is passed out with your faeces (stools). This can cause diarrhoea. You have to have made significant effort to lose weight through diet, exercise or changing your lifestyle before taking it.
Surgery
People with a BMI of 35 or more are described as morbidly obese. At this stage, the problem can be very hard to treat. Surgery may be considered to restrict the amount of food eaten or to interrupt the digestive process.
Surgery may also be an option for people with a BMI of 35 or more who have life-threatening cardiopulmonary problems - for example, severe sleep apnoea (a sleep disorder where a person experiences irregular breathing at night), obesity-related heart disease or diabetes and can be recommended to those who have a BMI more than 38 and failed to loose weight with diet for a long time.
There are three types of weight-loss surgery. The best type of surgery depends upon how much weight needs to be lost. All of them are done laproscopically (key hole surgery).
Sleeve gastrectomy involves the removal of the majority of the stomach to create a smaller, tubular (sleeve-shaped) stomach that can hold less food and is resistant to stretching.
Lap banding, can be adjusted or removed. This procedure places a band around the top of the stomach. This causes the person to feel full after eating a small amount of food.
In gastric bypass, we create a small pouch in the stomach. The pouch is connected to the small intestine. These changes cause the person to feel full after eating a small amount of food. It also causes the body to absorb fewer calories from food.

Weight loss surgery can have complications, such as pain, infection, need for a second surgery, or nutrition problems. The specific complication depends upon which surgery is done and if the person has other medical problems. There is a smaller risk of complications when weight loss surgery is done in centres with a great deal of experience. Less than 1 in 100 people die because of weight loss surgery.
Bariatric surgery has emerged as a viable option to reduce weight in morbidly obese people. In addition, it leads to substantial weight loss and amelioration of diabetes, obstructive sleep apnoea and other co-morbid conditions.
Current guidelines for application of bariatric surgery are
BMI above40 without co-morbidity
BMI above 35 with co-morbidity
  o Morbidities in Asian Indians occur at lower level of BMI than other races. We have data suggesting lower cut-offs for BMI and WC, and application of drug treatment should also be done earlier, it is proposed to have revised limit of BMI for bariatric surgery
  o Suggested for bariatric surgery
BMI above 32.5 with co-morbidity not responding to optimal medical management including weight loss drugs or causing incapacitation
BMI above 37.5 without co-morbidity not responding to optimal medical management including weight loss drugs or causing incapacitation
After Surgery
People lose about 60 percent of their extra weight. The amount of weight lost depends upon the nature of surgery conducted. Other health problems (e.g. diabetes or arthritis) often improve after weight loss surgery. After surgery, it is important to eat the right foods and exercise to stay healthy. Help with diet and exercise planning is available at Max Healthcare.
List of Services
Health Facts
Team that Cares
International Patient Services
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