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Harmful Impacts Of Obesity

By Dr. Pradeep Chowbey in Max Institute of Laparoscopic, Endoscopic & Bariatric Surgery

Dec 14 , 2021 | 6 min read

Every one in six adults is obese; one in ten is Diabetic, alerts WHO’s report on ‘The World Health Statistics”. A whopping 40% to 60% Type 2 Diabetics are people who are obese. India today sits on the ticking time bomb of two closely interlinked epidemics- Obesity and Type 2 Diabetes, aptly termed DIABESITY. As India makes rapid economic growth, its society undergoes a radical socio-economic and cultural transition. With a burgeoning middle class and increased purchasing power among masses, people in our country have experienced far-reaching changes- in their means, aspirations and lifestyles. The one major negative fallout of this has been an injurious change in the eating habits of adults and children alike. Eating food high in complex carbohydrates, sugars and saturated fats together with sedentary lifestyles of reduced physical activity have caused an alarming increase in the prevalence of both diabetes and obesity. Obesity rates have doubled worldwide since 1980’s.

Sample this-

“Every ten Kilograms of weight gain reduces life by three years. An obese person with a BMI of say 45 has shortened his life by nearly 14 years already. That is the reason why we do not see old obese person because majority of them will not survive.”

The harmful impacts of obesity and diabetes are grave and multiple, extending beyond the physiological to damage also the emotional and psychological health of patients.

The most common disorders related to obesity and diabetes include:

  • High blood pressure,
  • High cholesterol,
  • Heart disease, stroke,
  • Gallbladder disease,
  • Gastro-esophageal reflux disease,
  • Osteoarthritis (joint problems)
  • Sleep apnoea (snoring, daytime sleeping)
  • Infertility
  • Psychological problems, stress, anxiety, depression, intimacy issues.

Remember that

Heart disease is one of the leading causes of death in both obese people as well as diabetics.

WHAT GOES WRONG?

Studies have shown that insulin produced in the body is adequate to support lean body mass. However, as the fat content of a body increases so does its demand for insulin. To add to the problem, with greater fat the sensitivity of receptors towards insulin in our body also diminishes. Thus, in Obese people the negative combination of these two phenomena sets off Diabetes Mellitus. With a strong and direct co-relation between weight gain and the occurrence of Diabetes, the more severe the obesity, the more stubborn will be the disease.

The one key fact that thus becomes clear is the inevitable requirement to treat extra weight as a necessary condition to cure diabetes in obese people. There is enormous evidence the world over that confirms that reducing weight in obese adults and children helps treat the disease of diabetes. It is common to find that once the ideal body weight of an obese diabetic is achieved, that person gets completely rid of the disorder and become non -diabetic. Such people then stay healthy and live long by maintaining an active lifestyle and optimum body weight, without any need for medicines or insulin.

THE COST BURDEN

There is a large body of research to show that medical costs of persons with diabetes and obesity are higher than people who are non-diabetic and not obese for the following key reasons- Obese and Diabetic people need to visit doctors more frequently, require long-term medication along with treatment of varied and often recurring complications caused by the interplay of diabetes and obesity.

TREATMENT

In diabetic patients who are also obese, the mainstays of treatment are oral medicines and insulin therapy as prescribed by their Diabetologist. However, if conventional treatments fail to control diabetes and the patients’ weight-loss efforts fail to yield results, such people should use surgical options without delay to protect their lives.

This is where Bariatric Surgery lends a helping hand.

Bariatric surgery is a weight loss surgery performed in obese persons who have failed to lose weight by conventional methods. The surgery results in sustainable long- term weight loss. In recent years, studies have shown that bariatric surgery has the ability to control diabetes. Researchers found that obese patients with Type 2 diabetes who underwent surgery for weight loss had a remarkable health improvement in curing diabetes after their surgery. Scientific reports have now demonstrated that substantial and long-term weight loss after bariatric surgery heals diabetes and increases the lifespan of patients by restoring them to good health. By undergoing bariatric surgery at a well-equipped medical centre, Diabetes can be alleviated or even cured completely. After surgery, many patients shift from insulin to oral medicines. Longevity and quality of life, both are improved.

However, what is really important in deciding to go for bariatric surgery is to get operated only from an able doctor proficient in this branch of surgery.

Bariatric/metabolic surgery has been in practice in India for nearly the last ten years. The surgery involves re-alignment of the stomach and intestines in a manner that the size of the stomach reduces, thereby reducing hunger. ‘Roux-en-Y Gastric Bypass’ and ‘Sleeve Gastrectomy’ are two popular bariatric procedures. These procedures are performed laparoscopic (key-hole surgery) giving the patients the benefits of quicker and safer recovery, significantly smaller scars, reduced pain and early return to routine activities.

Bariatric surgery can be considered in:

  • Patients with Type 2 diabetes who have consistently failed to lose weight beyond a point using conventional weight loss methods (dietary restriction, increased exercise and physical activity and medication)
  • Patients with BMI (body mass index = Weight/ height2) over 32.5kg/m2 with Type 2 diabetes
The chances of resolution of diabetes are high in patients who have had diabetes for less than 10 years.

We are a high volume centre and have conducted these procedures successfully on a large number of people for over two decades. In doing so, we have witnessed the life transforming experiences of our morbidly obese patients. These patients have benefitted in terms of weight loss as well as the complete cure or control of diabetes as well as its incidental problems like high blood pressure, heart disease, arthritis, snoring, obstructive sleep apnoea(breath holding while sleeping). Not only has their quality of life improved but they have also added happy healthy years to their lives.

WHERE TO GET IT DONE

For bariatric surgery to be successful, it is necessary to follow an expert multi-disciplinary team approach. This involves a team of experienced surgeons, physicians, anesthetists, nutritionists, physiotherapists, psychologists and support staff. The team works closely with the patients helping them at every step to adjust to their new eating habits and lifestyle changes. All medial centres performing bariatric surgeries should have modern equipment and infrastructure with fixtures, rooms and spaces specially designed for these patients.

The journey towards losing weight and controlling diabetes is a hard and sometimes lonely one. The love, support and motivation of family, friends and doctors encourage these patients to undertake this tough but rewarding journey.

“We have seen this surgery literally work as a magic wand. Patients who were at one point of time unable to walk from room to room or tie their shoe laces themselves were seen to be completely in control of their lives six months post operatively. It is an overwhelming experience for us as surgeons to see them 'living each day' in contrast to their everyday struggle to survive. The surgery not only improves the longevity and quality of life but also has a huge positive impact on the patient's confidence and self esteem.” Dr. Pradeep Chowbey, Chairman, Institute of Laparoscopic, Bariatric and Endoscopic Surgery, Max Super Specialty, Saket, New Delhi, India.